Individual
MARY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2051 NEWMARK AVE, COOS BAY, OR 97420-4728
(541) 888-5750
Mailing address
21 PEACH TREE LN, GANSEVOORT, NY 12831-2604
(940) 235-8163
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0019211
OR
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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