Individual
ADAM LEO KEITH YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3800 SE 22ND AVE, MAIL STOP: 04002/31D, PORTLAND, OR 97202-2918
(503) 797-3845
Mailing address
131 FETHERSTON AVE, LOWELL, MA 01852-1619
(978) 761-5442
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR12998
ME
Other
Enumeration date
07/14/2013
Last updated
07/14/2013
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