Individual
JASON PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3404 W SYLVANIA AVE, TOLEDO, OH 43623-4467
(419) 407-2663
Mailing address
857 VALLEY CIRCLE DR APT 103, SALINE, MI 48176-1453
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03443158
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03443158
PHARMACIST LICENSE
OH
Enumeration date
06/27/2023
Last updated
06/27/2023
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