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1942711106
RYAN MATTHEW NIELSON
LA GRANDE, OR
NPI
1942711106
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: OR 0016265)
Enumeration Date
2017-10-16
Last Update Date
2017-10-16
Business Address
RYAN MATTHEW NIELSON RPh
2212 ISLAND AVE STE 201
LA GRANDE, OR 97850-3949
Phone number: 541-963-8696
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Mailing Address
RYAN MATTHEW NIELSON RPh
2114 2ND ST
LA GRANDE, OR 97850-1707
Phone number: 801-420-8924
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