Individual
KAMAL KOTAICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 S HOLLY ST STE 1131, MEDFORD, OR 97501-3113
(800) 967-6816
Mailing address
140 S HOLLY ST STE 1131, MEDFORD, OR 97501-3113
(800) 967-6816
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0009624
OR
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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