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1114677655
SUSAN DANETTE JENSEN
CALDWELL, ID
NPI
1114677655
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183700000X Pharmacy Technician
(Licence: ID TT47289)
Enumeration Date
2022-03-27
Last Update Date
2022-03-27
Business Address
SUSAN DANETTE JENSEN TT47289
4110 S 10TH AVE
CALDWELL, ID 83605-5706
Phone number: 208-402-0154
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Mailing Address
SUSAN DANETTE JENSEN TT47289
4110 S 10TH AVE
CALDWELL, ID 83605-5706
Phone number: 208-402-0154
Copy
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