Individual
VICKI GAIL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1904 19TH AVE, LEWISTON, ID 83501
(208) 743-9127
(208) 743-4777
Mailing address
2178 23RD ST, CLARKSTON, WA 99403
(509) 751-0114
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13219
CO
183500000X
Pharmacist
5291
NM
183500000X
Pharmacist
Primary
P5631
ID
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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