Individual
DR. GORDON RALPH MCCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
905 YELLOWSTONE AVE, POCATELLO, ID 83201-4416
(208) 233-2382
(208) 233-2648
Mailing address
905 YELLOWSTONE AVE, POCATELLO, ID 83201-4416
(208) 233-2382
(208) 233-2648
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5103
ID
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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