Individual
BRADY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
1403 NORTH MERIDIAN RD, KUNA, ID 83634
(208) 922-9566
Mailing address
621 WASHINGTON ST S, TWIN FALLS, ID 83301
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6825
ID
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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