Individual
JACOB M CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2304 E LINCOLNWAY, CHEYENNE, WY 82001-5416
(307) 635-0241
Mailing address
4606 E 12TH ST UNIT 4, CHEYENNE, WY 82001-6785
(440) 759-0116
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4272
WY
Other
Enumeration date
11/01/2020
Last updated
11/01/2020
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