Individual
KELLY JO KNUTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1775 THOMPSON ROAD, COOS BAY, OR 97420
(541) 269-8160
Mailing address
915 ARAGO AVENUE, COOS BAY, OR 97420
(541) 888-4183
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0000026
OR
Other
Enumeration date
10/04/2006
Last updated
07/21/2022
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