Individual
KEITH RENNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
730 BIDDLE RD, MEDFORD, OR 97504-6116
(541) 494-3860
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016991
OR
Other
Enumeration date
12/17/2018
Last updated
02/02/2022
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