TAKODA AVERETT
Individual Provider (NPI-1)
Active
Pharmacist
Provider Information
- NPI Number
1902522600- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1015 YOUNG ST., POCATELLO, ID, 832018320
- Phone
- (410) 200-1000
Specialties & Taxonomies
Pharmacist
Primary License: ID #P10076
All Addresses
MAILING
2476 GREENFIELD DR
POCATELLO, ID, 832017600