IDAHO STATE UNIVERSITY

NPI # 

Practice Address:

990 South 8Th

Pocatello, ID, 83209

Practice Phone:

208-282-3407

License Number:

349CP

License State:

ID

Taxonomy Grouping:

Suppliers

Taxonomy Classification:

Pharmacy

Taxonomy Specialization:

Clinic Pharmacy

Taxonomy Code:

3336C0002X