Individual
LOGAN WOOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
604 N FIFTH AVE, SANDPOINT, ID 83864-1520
(208) 263-1408
Mailing address
550 LARKSPUR ST APT B304, PONDERAY, ID 83852-5052
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8921
ID
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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