Individual
KENNY DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Mailing address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9040
ID
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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