RICHARD WAYNE BLACK

IDAHO FALLS, ID
NPI1093545014
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: ID  7161471)
Enumeration Date2024-08-05
Last Update Date2024-08-05
Business Address
RICHARD WAYNE BLACK
2325 CORONADO ST
IDAHO FALLS, ID 83404-7407
Phone number: 208-557-2738
Mailing Address
RICHARD WAYNE BLACK
2325 CORONADO ST
IDAHO FALLS, ID 83404-7407
Phone number:
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