Individual
THEODORE SANDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
208 W IRONWOOD DR, COEUR D ALENE, ID 83814-2640
(208) 664-3185
Mailing address
3003 S PERRY ST APT 52, SPOKANE, WA 99203-3986
(253) 508-1900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P11270
ID
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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