Individual
MR. KIM E. TILLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2638 LONGBOW DR, TWIN FALLS, ID 83301-8946
(208) 735-4076
(208) 324-4599
Mailing address
2638 LONGBOW DR, TWIN FALLS, ID 83301-8946
(208) 735-4076
(208) 324-4599
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
P4585
ID
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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