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Individual

PHILIP ROBERT PETRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8169
Mailing address
63472 2ND STREET LOOP, COOS BAY, OR 97420-4538
(503) 421-0705

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0015773
OR

Other

Enumeration date
05/26/2022
Last updated
05/26/2022
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