Individual
MS. JONI RENEE KILLGORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
500 SUMMER ST NE, SALEM, OR 97301-1063
(503) 945-6710
Mailing address
500 SUMMER ST NE, SALEM, OR 97301-1063
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T-0009149
OR
Other
Enumeration date
05/02/2007
Last updated
09/11/2008
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