Individual
DR. COREY DAVID RIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
8380 HARRISON ST, LA VISTA, NE 68128-2918
(402) 592-7970
Mailing address
5949 CLEARWATER DR, FORT CALHOUN, NE 68023-5060
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16774
NH
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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