Individual
DR. MELISSA ANN FOSSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
19 MYRTLE ST, MEDFORD, OR 97504-7337
(541) 773-3863
(541) 776-2892
Mailing address
900 E MAIN ST, MEDFORD, OR 97504-7136
54184277704
(541) 842-7640
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0013796-P
OR
Other
Enumeration date
05/20/2012
Last updated
08/16/2017
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