Individual
MR. EDWARD LEWIS WYANT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-4251
Mailing address
8801 JOHN DAY DR, GOLD HILL, OR 97525-5525
(541) 855-7512
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9432
OR
Other
Enumeration date
11/10/2005
Last updated
07/08/2007
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