Individual
DR. MICHAEL JOHN GENCZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1020 S 1ST AVE, COOS BAY, OR 97420
(541) 269-4033
Mailing address
1020 S 1ST AVE, COOS BAY, OR 97420
(541) 269-4033
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0012481
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
ORRPH-0012481
OR
Other
Enumeration date
11/29/2010
Last updated
05/03/2017
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