Individual
ANDREW MATHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
451 DEINHARD LN, MCCALL, ID 83638-4800
(208) 634-4929
Mailing address
6928 N MOON DRUMMER WAY, MERIDIAN, ID 83646-4851
(208) 871-8258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10077
ID
Other
Enumeration date
07/09/2022
Last updated
07/09/2022
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