Individual
MAN THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
91111 CAPE ARAGO HWY, COOS BAY, OR 97420-7637
(971) 777-4747
Mailing address
91111 CAPE ARAGO HWY, COOS BAY, OR 97420-7637
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0018598
OR
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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