Individual
DWIGHT K NYBERG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
507 S ASH ST, BUFFALO, MO 65622-5464
(417) 345-2321
(417) 345-8837
Mailing address
PO BOX 860, BUFFALO, MO 65622-0860
(417) 345-2321
(417) 345-8837
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
028845
MO
1835G0303X
Geriatric Pharmacist
028845
MO
1835P1200X
Pharmacotherapy Pharmacist
028845
MO
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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