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Individual

DR. JEFFREY GRUNDHAUSER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
89 W 2ND S, SODA SPRINGS, ID 83276-1509
(208) 547-3300
Mailing address
515 RAVEN WAY APT D, CHUBBUCK, ID 83202-1966
(208) 237-9213

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7312
ID

Other

Enumeration date
12/21/2015
Last updated
12/21/2015
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