Individual
SALLY MICHELLE BOOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 382-4321
Mailing address
64624 BOONES BOROUGH DR, BEND, OR 97701-8015
(541) 771-4994
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
7543
OR
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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