Individual
JACOB RUSSEL KLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 COLUMBIA BLVD, BLOOMSBURG, PA 17815-2360
(570) 387-6183
Mailing address
511 MOUNT PLEASANT RD, BLOOMSBURG, PA 17815-7242
(570) 317-4568
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP459047
PA
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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