Individual
DR. BRYAN JORDON GIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
65 SE GOODFELLOW ST, ONTARIO, OR 97914-3016
(541) 889-6288
(541) 889-5675
Mailing address
514 N RIPPLEROCK PL, STAR, ID 83669-5127
(801) 540-9496
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
P6436
ID
183500000X
Pharmacist
Primary
RPH-0012482
OR
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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