Individual
DR. JEFFREY KOUDELKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
1427 MAIN ST, GOODING, ID 83330-1838
(208) 934-4709
(208) 934-4905
Mailing address
1427 MAIN ST, GOODING, ID 83330-1838
(208) 934-4709
(208) 934-4905
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5033
ID
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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