Individual
MR. KENNETH T MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2130 MARCOLA RD, SPRINGFIELD, OR 97477-2592
(541) 747-3361
Mailing address
2990 CAMROSE ST, EUGENE, OR 97404-1726
(541) 607-9554
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0009590
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0009590
STATE PHARMACY LICENSE
OR
Enumeration date
04/20/2011
Last updated
04/20/2011
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