Individual
TIMOTHY L LICHLYTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2924 SISKIYOU BLVD STE 102, MEDFORD, OR 97504-8194
(541) 773-5356
Mailing address
4800 CRATER LAKE AVE, MEDFORD, OR 97504-9753
(541) 690-1130
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0006953
OR
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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