Individual
IAN GASPAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-4965
Mailing address
301 FISHER ST, KEESLER AFB, MS 39534-2508
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021793A
IN
Other
Enumeration date
08/29/2011
Last updated
05/12/2018
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