Individual
DR. MATTHEW R BACKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
330 CHILOQUIN BLVD, CHILOQUIN, OR 97624-6773
(800) 552-6290
Mailing address
3949 S 6TH ST, KLAMATH FALLS, OR 97603-4746
(800) 552-6290
(541) 880-0560
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11103
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115761
—
OR
Enumeration date
07/29/2005
Last updated
03/07/2023
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