Individual
DR. KEITH R FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
221 N WESTERN AVE, WEST PEORIA, IL 61604-5640
(309) 673-0665
(309) 673-3593
Mailing address
221 N WESTERN AVE, WEST PEORIA, IL 61604-5640
(309) 673-0665
(309) 673-3593
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051299712
IL
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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