Individual
RACHEL OCTAVIA WYLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1226 MULBERRY ST, MOUNT VERNON, IN 47620-1358
(618) 218-6502
Mailing address
1226 MULBERRY ST, MOUNT VERNON, IN 47620-1358
(618) 218-6502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051301509
IL
183500000X
Pharmacist
Primary
26028287A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26028287A
—
IN
Enumeration date
02/20/2020
Last updated
02/20/2020
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