Individual
MR. RICHARD BYRON ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
2330 NEZ PERCE DR, LEWISTON, ID 83501-4107
(208) 798-0481
(208) 798-0715
Mailing address
2330 NEZ PERCE DR, LEWISTON, ID 83501-4107
(208) 798-0481
(208) 798-0715
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P-4526
ID
183500000X
Pharmacist
PH 00009240
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P-4526
IDAHO PHARMACIST LICENSE
ID
Enumeration date
11/15/2010
Last updated
11/15/2010
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