Individual
MS. DIANE LIPSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 EAST BLAINE ST., CLADWELL, ID 83605
(208) 454-0484
Mailing address
2500 EAST BLAINE ST., CLADWELL, ID 83605
(208) 454-0484
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5978
ID
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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