Individual
KOGE EJEDEPANG-KOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
2504 LOTUS CREEK DR, VIRGINIA BEACH, VA 23456-6459
(757) 427-0920
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0202012951
VA
Other
Enumeration date
11/03/2008
Last updated
11/03/2008
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