Individual
SHAWNA CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-2500
(208) 814-2920
Mailing address
738 PARK AVE, POCATELLO, ID 83201-3763
(208) 604-0928
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6271
ID
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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