Individual
DR. JACOB SAMUEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
111 UNION AVE, GRANTS PASS, OR 97527-5579
(541) 471-4873
Mailing address
111 UNION AVE, GRANTS PASS, OR 97527-5579
(541) 471-4873
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0016203
OR
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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