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Individual

JAY LIDSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
731 CEMETERY LN, ASPEN, CO 81611-1141
(970) 319-3474
Mailing address
731 CEMETERY LN, ASPEN, CO 81611-1141

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
18757
CO
183500000X
Pharmacist
PS17282
FL
1835N1003X
Nutrition Support Pharmacist
Primary
18757
CO
1835N1003X
Nutrition Support Pharmacist
PU1952
FL

Other

Enumeration date
01/27/2010
Last updated
07/02/2012
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