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1205135498
ROBERT W MICKELSON
CALDWELL, ID
NPI
1205135498
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: ID P5300)
Enumeration Date
2011-03-28
Last Update Date
2011-03-28
Business Address
-- ROBERT W MICKELSON
2809 CLEVELAND BLVD
CALDWELL, ID 83605-4443
Phone number: 208-455-1094
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Mailing Address
-- ROBERT W MICKELSON
16122 HORIZON DR
CALDWELL, ID 83607-8298
Phone number: 208-454-8890
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