Individual
SAMANTHA DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
490 N 2ND E, MOUNTAIN HOME, ID 83647-2729
(208) 587-3346
Mailing address
490 N 2ND E, MOUNTAIN HOME, ID 83647-2729
(208) 587-3346
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7283
ID
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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