SHANE ELLIS WITHERS

REXBURG, ID
NPI1952956906
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: ID  P8493)
Enumeration Date2019-08-06
Last Update Date2023-11-27
Business Address
-- SHANE ELLIS WITHERS RPH
164 E. MAIN
REXBURG, ID 83440
Phone number: 208-227-5076
Mailing Address
-- SHANE ELLIS WITHERS RPH
4482 WEST 1000 NORTH
REXBURG, ID 83440
Phone number: 208-313-1736
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