Individual
JARED K LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD., RPH
Contact information
Practice address
3160 E 17TH ST STE 164, AMMON, ID 83406-6784
(208) 529-1795
Mailing address
3160 E 17TH ST STE 164, AMMON, ID 83406-6784
(208) 529-1795
(208) 529-1838
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
60514388
WA
183500000X
Pharmacist
9321235
UT
183500000X
Pharmacist
Primary
P7115
ID
Other
Enumeration date
12/04/2014
Last updated
01/27/2023
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