Individual
CHRISTOPHER ADAM MECKLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1904 19TH AVE, LEWISTON, ID 83501-4069
(208) 743-9127
Mailing address
3137 CHERRY TREE CIRCLE, LEWISTON, ID 83501
(208) 743-9127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6870
ID
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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