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Individual
DR. PHILLIP TYLER LABAUCH
Active
Individual
DR. PHILLIP TYLER LABAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19024
NC
183500000X
Pharmacist
37545
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19024
PHARMACIST LICENSE
NC
01
—
37545
PHARMACIST LICENSE
SC
Enumeration date
09/13/2012
Last updated
11/10/2021
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