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Individual

TED HOGGARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
150 MELTON RD, CRESWELL, OR 97426-9453
(541) 895-9810
Mailing address
150 MELTON RD, CRESWELL, OR 97426-9453
(541) 895-9810

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9827
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9827
STATE PHARMACIST LICENSE
OR
Enumeration date
02/09/2012
Last updated
02/09/2012
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