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Derek Johannson Valid NPI

Individual provider · Pharmacist · Alturas, CA

NPI
1720370448
Type
Individual (Type 1)
Primary specialty
Pharmacist
Specialty group
Pharmacy Service Providers
Taxonomy code
183500000X
License number
64275 (CA)
Sex
Male
Sole proprietor
No
Enumerated
2011-05-12
Last updated
2011-05-12
Practice location
432 N Main St
Alturas, CA 96101-3458
(530) 233-3113

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Derek Johannson — NPI 1720370448