Tommy Joe Gross, RPH

NPI #1235539479 in Lewiston, Idaho

Provider Information

NPI Number: 1235539479
Entity Type: Individual
Name: Tommy Joe Gross, RPH
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Aug 25, 2014
Last Updated: Aug 25, 2014

Practice Location

Address: 1815 21ST ST
City: Lewiston
State: Idaho
ZIP Code: 83501-4103
Phone: (208) 746-0579

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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