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1386924348
JONATHAN MARK BACON
CHARLOTTE, NC
NPI
1386924348
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: NC 7757)
Enumeration Date
2011-08-23
Last Update Date
2011-08-23
Business Address
Mr. JONATHAN MARK BACON R.Ph.
1533 SOUTH BLVD
CHARLOTTE, NC 28203-4723
Phone number: 704-342-4558
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Mailing Address
Mr. JONATHAN MARK BACON R.Ph.
701 ROYAL CT APT # 705
CHARLOTTE, NC 28202-2748
Phone number: 704-516-5219
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