Richard Lee Wilgus

NPI #1932713765 in Kellogg, Idaho

Provider Information

NPI Number: 1932713765
Entity Type: Individual
Name: Richard Lee Wilgus
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Aug 31, 2020
Last Updated: Aug 31, 2020

Practice Location

Address: 131 W CAMERON AVE
City: Kellogg
State: Idaho
ZIP Code: 83837-2359
Phone: (208) 784-6221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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