Individual
CASEY L COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 19TH AVE, LEWISTON, ID 83501-4069
(208) 743-9127
Mailing address
1904 19TH AVE, LEWISTON, ID 83501-4069
(208) 743-9127
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CT46803
ID
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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