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1134460009
GLENN OTAKE
SAN ANTONIO, TX
NPI
1134460009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: TX 28645)
Enumeration Date
2013-03-01
Last Update Date
2013-03-01
Business Address
Mr. GLENN OTAKE RPH
9238 N LOOP 1604 W
SAN ANTONIO, TX 78249-2577
Phone number: 210-682-3419
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Mailing Address
Mr. GLENN OTAKE RPH
8523 BRAUN KNL
SAN ANTONIO, TX 78254-5584
Phone number: 210-844-9426
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