Individual
DR. RICHARD LEWIS GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
100 FERGUS ST, ROY, MT 59471-0014
(406) 464-7571
Mailing address
100 FERGUS ST, ROY, MT 59471-0014
(406) 464-7571
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
1838
MT
1835G0303X
Geriatric Pharmacist
Primary
1838
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1838
MONTANA BOARD OF PHARMACY LICENSE NUMBER
MT
Enumeration date
07/16/2009
Last updated
07/16/2009
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