Individual
KENNETH ROBERT SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1123 ADAMS AVE, LA GRANDE, OR 97850-2692
(541) 963-5741
(541) 963-6332
Mailing address
1123 ADAMS AVE, LA GRANDE, OR 97850-2692
(541) 963-5741
(541) 963-6332
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6173
OR
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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