Individual
MARY T SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
451 DEINHARD LN, MCCALL, ID 83638-4800
(208) 634-4929
Mailing address
451 DEINHARD LN, MCCALL, ID 83638-4800
(208) 634-4929
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4757
ID
183500000X
Pharmacist
RPH 35443
CA
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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