Individual
DR. MICHAEL ORION TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
1301 CENTER DR, MEDFORD, OR 97501-7938
(541) 857-4683
Mailing address
1301 CENTER DR, MEDFORD, OR 97501-7938
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0014225
OR
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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