Individual
ROGER WESLEY WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
274 RESERVOIR DR, LEWISTON, ID 83501-9637
(208) 413-3019
Mailing address
PO BOX 87, OSBURN, ID 83849-0087
(208) 413-3019
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4785
ID
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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