Individual
JACKSON WIMBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1749 W WALNUT ST, ROGERS, AR 72756-3323
(479) 246-0871
Mailing address
1749 W WALNUT ST, ROGERS, AR 72756-3323
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD15082
AR
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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