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Individual

CODY LANGAAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1904 19TH AVE, LEWISTON, ID 83501-4069
(208) 743-9127
Mailing address
1904 19TH AVE, LEWISTON, ID 83501-4069
(208) 743-9127

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
122868
MN
183500000X
Pharmacist
Primary
P7648
ID
183500000X
Pharmacist
RPH5870
ND

Other

Enumeration date
11/02/2016
Last updated
11/02/2016
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