Individual
MARC DITOMMASO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2355 W MAIN ST, MEDFORD, OR 97501-2161
(541) 772-3014
(541) 772-4852
Mailing address
2355 W MAIN ST, MEDFORD, OR 97501-2161
(541) 772-3014
(541) 772-4852
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0010066
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010066
OREGON BOARD OF PHARMACY
OR
Enumeration date
02/22/2012
Last updated
02/22/2012
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