ROBERT W MICKELSON

CALDWELL, ID
NPI1205135498
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: ID  P5300)
Enumeration Date2011-03-28
Last Update Date2011-03-28
Business Address
-- ROBERT W MICKELSON
2809 CLEVELAND BLVD
CALDWELL, ID 83605-4443
Phone number: 208-455-1094
Mailing Address
-- ROBERT W MICKELSON
16122 HORIZON DR
CALDWELL, ID 83607-8298
Phone number: 208-454-8890