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1962042242
TRAVIS TUAN TANG
ROSEBURG, OR
NPI
1962042242
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
3336C0003X Pharmacy, Community/Retail Pharmacy
(Licence: OR RPH-0017619)
Enumeration Date
2020-01-14
Last Update Date
2020-01-14
Business Address
TRAVIS TUAN TANG
2125 NW STEWART PKWY
ROSEBURG, OR 97471-1693
Phone number: 541-957-8544
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Mailing Address
TRAVIS TUAN TANG
1064 NE LINCOLN ST
ROSEBURG, OR 97470-2121
Phone number: 541-580-8907
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