Individual
BRAD CAMMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1648 E IDAHO AVE, ONTARIO, OR 97914-3008
(541) 889-6315
Mailing address
1648 E IDAHO AVE, ONTARIO, OR 97914-3008
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0011434
OR
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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