Individual
DR. JIMMY COTHREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3475 E 17TH ST, AMMON, ID 83406-6781
(208) 380-0306
Mailing address
3475 E 17TH ST, AMMON, ID 83406-6781
(208) 380-0306
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10098
ID
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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