Individual
JACOB KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
200 W US HIGHWAY 80, WHITE OAK, TX 75693-2006
(903) 297-9896
Mailing address
2601 N EASTMAN RD APT 1400C, LONGVIEW, TX 75605-4041
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
249572
TX
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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