Individual
MARK KEYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1555 NORTHGATE MILE, IDAHO FALLS, ID 83401-2014
(208) 535-2553
Mailing address
1555 NORTHGATE MILE, IDAHO FALLS, ID 83401-2014
(208) 535-2553
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6255
ID
Other
Enumeration date
10/31/2010
Last updated
10/31/2010
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