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Individual

RUDOLF DICKEINSTEIN TANGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
2000 CRATER LAKE HWY, T0613, MEDFORD, OR 97504-4161
(541) 779-5110
Mailing address
2000 CRATER LAKE HWY, T0613, MEDFORD, OR 97504-4161
(541) 779-5110

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0012398
OR

Other

Enumeration date
06/30/2011
Last updated
06/30/2011
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