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Individual

DOUG L KIDDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
520 N 3RD AVE, SANDPOINT, ID 83864-1507
(208) 305-5196
Mailing address
18 MEADOWLARK LN, SANDPOINT, ID 83864-7526
(208) 305-5196

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4976
ID
183500000X
Pharmacist
PH00018504
WA

Other

Enumeration date
09/21/2007
Last updated
02/24/2009
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