Individual
DR. WILLIAM JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4240 YELLOWSTONE AVE, CHUBBUCK, ID 83202-2420
(208) 237-5091
(208) 237-6897
Mailing address
4240 YELLOWSTONE AVE, CHUBBUCK, ID 83202-2420
(208) 237-5091
(208) 237-6897
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6398
ID
Other
Enumeration date
07/19/2014
Last updated
07/19/2014
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