Most Relevant Information
Provider Data
| NPI Number: | 1003477415 |
| Provider Name: | JORDIN MILLWARD PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 1835P1200X |
| Specialty: | Pharmacist |
| License Number: | P8363 |
Most Important Dates
| Enumeration Date: | 06/26/2019 |
| Last Updated: | 06/26/2019 |
Provider Practice Location
465 MEMORIAL DR
POCATELLO
ID
832014008
Practice Location Phone/Fax
| Phone: | 2082823387 |
| Fax: |
Provider Mailing Location
465 MEMORIAL DR
POCATELLO
ID
832014008
Provider Mailing Phone/Fax
| Phone: | 2082413627 |
| Fax: |