Individual
MELANIE JULIANA HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
921 S 8TH AVE, POCATELLO, ID 83209-0002
(208) 282-4636
Mailing address
921 S 8TH AVE, POCATELLO, ID 83209-0002
(208) 282-4636
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E45513
ID
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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