Individual
JEREMY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
164 E MAIN ST, REXBURG, ID 83440-1912
(208) 227-5076
(208) 227-5079
Mailing address
164 E MAIN ST, REXBURG, ID 83440-1912
(208) 227-5076
(208) 227-5079
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7542
ID
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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