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Individual

EIZABETH A KELLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
708 EAST SELTICE WAY, POST FALLS, ID 83854
(208) 777-4071
(208) 773-0913
Mailing address
708 EAST SELTICE WAY, POST FALLS, ID 83854
(208) 777-4071
(208) 773-0913

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
18591
CO
183500000X
Pharmacist
Primary
PH00055898
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18591
LICENSE
CO
01
PH00055898
LICENSE
WA
Enumeration date
09/19/2013
Last updated
09/19/2013
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