Provider Demographics
NPI:1568484483
Name:ESTABROOK, DAVID REUBEN II (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:REUBEN
Last Name:ESTABROOK
Suffix:II
Gender:M
Credentials:RPH
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Mailing Address - Street 1:2865 DAGGETT AVE
Mailing Address - Street 2:WEST ANTICOAGULATION CLINIC WEST INFUSION
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601
Mailing Address - Country:US
Mailing Address - Phone:541-885-2653
Mailing Address - Fax:541-883-4153
Practice Address - Street 1:2865 DAGGETT AVE
Practice Address - Street 2:WEST ANTICOAGULATION CLINIC WEST INFUSION
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601
Practice Address - Country:US
Practice Address - Phone:541-885-2653
Practice Address - Fax:541-883-4153
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OR0006524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist