Individual
JIMMY DALE KEITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
207 OAKWAY RIDGE CT, KERNERSVILLE, NC 27284-7455
(336) 992-6814
Mailing address
1427A NC HIGHWAY 68 N, OAK RIDGE, NC 27310-9768
(336) 703-7580
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10715
NC
Other
Enumeration date
09/25/2009
Last updated
07/18/2023
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