Individual
RONALD DONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
35 STATELINE RD W, SOUTHAVEN, MS 38671-1705
(662) 342-2906
Mailing address
35 STATELINE RD W, SOUTHAVEN, MS 38671-1705
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-5904
MS
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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