Individual
DR. EZEKIEL KEERENG KESITILWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1980 MCCULLOCH BLVD N, LAKE HAVASU CITY, AZ 86403-0969
(928) 854-8281
(928) 453-3969
Mailing address
2734 PASEO VERDE, LAKE HAVASU CITY, AZ 86406-7748
(928) 230-9812
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
S013695
AZ
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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