Individual
TAVIS JOHN OSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
217 W IRONWOOD DR, COEUR D ALENE, ID 83814-2651
(208) 765-9586
(208) 765-6922
Mailing address
217 W IRONWOOD DR, COEUR D ALENE, ID 83814-2651
(208) 765-9586
(208) 765-6922
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5650
ID
Other
Enumeration date
07/08/2012
Last updated
07/08/2012
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