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1235539479
TOMMY JOE GROSS
LEWISTON, ID
NPI
1235539479
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: ID p4833)
Enumeration Date
2014-08-25
Last Update Date
2014-08-25
Business Address
-- TOMMY JOE GROSS rph
1815 21ST ST
LEWISTON, ID 83501-4103
Phone number: 208-746-0579
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Mailing Address
-- TOMMY JOE GROSS rph
1815 21ST ST
LEWISTON, ID 83501-4103
Phone number: 208-746-0579
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