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Individual
DR. JUSTIN D NICHOLLS
Active
Individual
DR. JUSTIN D NICHOLLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, BCOP, BCPS
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
3984
MT
183500000X
Pharmacist
PH00052231
WA
183500000X
Pharmacist
Primary
RPH-0010070
OR
Other
Enumeration date
06/18/2005
Last updated
10/17/2014
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