Individual
CATHI BAILY KETTERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM. D
Contact information
Practice address
233 EDWARDS DR, TWIN FALLS, ID 83301-0105
(208) 308-4292
(208) 733-3942
Mailing address
233 EDWARDS DR, TWIN FALLS, ID 83301-0105
(208) 308-4292
(208) 733-3942
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5099
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P5099
PHARMACY LICENSE
ID
Enumeration date
01/25/2012
Last updated
01/25/2012
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