Shane Ellis Withers, RPH

NPI #1952956906 in Rexburg, Idaho

Provider Information

NPI Number: 1952956906
Entity Type: Individual
Name: Shane Ellis Withers, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Aug 6, 2019
Last Updated: Nov 27, 2023

Practice Location

Address: 164 E. MAIN
City: Rexburg
State: Idaho
ZIP Code: 83440
Phone: (208) 227-5076

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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