Individual
RYAN F LYTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
10580 W USTICK RD, BOISE, ID 83704-5267
(208) 377-3581
Mailing address
13501 W WITTENBURG ST, BOISE, ID 83713-0842
(208) 938-2091
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6435
ID
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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