Individual
ALICIA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1545 E 6TH ST, WEISER, ID 83672-1495
(208) 549-8777
Mailing address
1545 E 6TH ST, WEISER, ID 83672-1495
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CT17935
ID
Other
Enumeration date
06/06/2020
Last updated
06/06/2020
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