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Individual
MR. PAUL SODERBERG
Active
Individual
MR. PAUL SODERBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15393
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15393
STATE BOARD OF PHARMACY-PHARMACIST LICENSE
CO
Enumeration date
08/30/2012
Last updated
08/30/2012
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