Most Relevant Information
Provider Data
| NPI Number: | 1003430943 |
| Provider Name: | ALICIA GONZALEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: | CT17935 |
Most Important Dates
| Enumeration Date: | 06/06/2020 |
| Last Updated: | 06/06/2020 |
Provider Practice Location
1545 E 6TH ST
WEISER
ID
836721495
Practice Location Phone/Fax
| Phone: | 2085498777 |
| Fax: |
Provider Mailing Location
1545 E 6TH ST
WEISER
ID
836721495
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |