COENRAAD JACOBUS VANDENBERG

TACOMA, WA
NPI1023371440
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: WA  PH00050052)
Enumeration Date2012-06-20
Last Update Date2012-06-20
Business Address
Mr. COENRAAD JACOBUS VANDENBERG
104 MILITARY RD E
TACOMA, WA 98445-1243
Phone number: 253-538-2611
Mailing Address
Mr. COENRAAD JACOBUS VANDENBERG
104 MILITARY RD E
TACOMA, WA 98445-1243
Phone number: 253-538-2611
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