Individual
GAYLORD EARL VICTORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1602 EDGINGTON AVE, ELDORA, IA 50627-1626
(641) 858-3567
Mailing address
2213 N TERRACE DR, WEBSTER CITY, IA 50595-3026
(515) 832-5284
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15091
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15091
IOWA PHARMACIST'S LICENSE
IA
Enumeration date
02/26/2007
Last updated
06/21/2013
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