Individual
KEITH THOMAS WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4747 S HIGHWAY 95, FORT MOHAVE, AZ 86426-9377
(928) 330-3704
(928) 330-3707
Mailing address
4747 S HIGHWAY 95, FORT MOHAVE, AZ 86426-9377
(928) 330-3704
(928) 330-3707
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
S019853
AZ
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
S019853
AZ
Other
Enumeration date
09/05/2013
Last updated
10/25/2020
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