Richard Wayne Black
NPI #1093545014 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1093545014
- Entity Type
- Individual
- Name
- Richard Wayne Black
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Pharmacist
- Enumeration Date
- Aug 5, 2024
- Last Updated
- Aug 5, 2024
Practice Location
- Address
- 2325 CORONADO ST
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-7407
- Phone
- (208) 557-2738
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
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