Individual
MR. PAUL SODERBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
POB 1302, 101 MARTIN WAY, KREMMLING, CO 80459-1302
(970) 724-3205
(970) 724-3225
Mailing address
PO BOX 1302, 308 10TH ST N., KREMMLING, CO 80459-1302
(970) 724-3205
(970) 724-3225
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15393
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15393
STATE BOARD OF PHARMACY-PHARMACIST LICENSE
CO
Enumeration date
08/30/2012
Last updated
08/30/2012
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