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Individual

KEITH RYOTA YAMABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2250 CORONADO ST STE A, IDAHO FALLS, ID 83404-7552
(208) 542-4140
(208) 523-4203
Mailing address
2250 CORONADO ST STE A, IDAHO FALLS, ID 83404-7552
(208) 542-4140
(208) 523-4203

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
P9707
ID

Other

Enumeration date
12/01/2021
Last updated
12/01/2021
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