Dorsie Thomas Sullenger

NPI #1831682194 in Rexburg, Idaho

Provider Information

NPI Number
1831682194
Entity Type
Individual
Name
Dorsie Thomas Sullenger
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Pharmacist
Enumeration Date
Jun 12, 2018
Last Updated
Jun 12, 2018

Practice Location

Address
450 E MAIN ST
State
Idaho
ZIP Code
83440-2048
Phone
(208) 359-6484

Specialties & Taxonomy Codes

Specialty
Pharmacist

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