Individual
GORDON RILEY MELVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1570 E FAIRVIEW AVE, MERIDIAN, ID 83642-1821
(208) 888-0034
Mailing address
1570 E FAIRVIEW AVE, MERIDIAN, ID 83642-1821
(208) 888-0034
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P3657
ID
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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