Individual
JACOB EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 W MAIN ST, LYONS, KS 67554-1708
(620) 509-2169
Mailing address
PO BOX 167, LYONS, KS 67554-0167
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
1-105894
KS
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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