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Individual

SPENCER A GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
2219 12TH AVE RD, NAMPA, ID 83686-6313
(208) 318-0536
(208) 318-0542
Mailing address
2219 12TH AVE RD, NAMPA, ID 83686-6313
(208) 318-0536
(208) 318-0542

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6834
ID

Other

Enumeration date
07/07/2013
Last updated
12/08/2014
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