Individual
MICHAEL GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1680 E HANDEL ST, MERIDIAN, ID 83646-4708
(208) 895-8216
Mailing address
1680 E HANDEL ST, MERIDIAN, ID 83646-4708
(208) 895-8216
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4267
ID
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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