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Individual

BARRY LYNN KEELER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
DOMINICAN PLAZA PHARMACY, 1595 SOQUEL DR SUITE 120, SANTA CRUZ, CA 95065
(831) 462-7726
(831) 462-7615
Mailing address
3096 W LEDYARD WAY, APTOS, CA 95003-3829
(831) 234-0322

Taxonomy

Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
29416
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29416
CALIFORNIA STATE BOARD OF PHARMACY
CA
Enumeration date
09/07/2018
Last updated
09/07/2018
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