Individual
MR. GARY LANE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
22 LARRY JOE HARLESS DR., GILBERT, WV 25621
(304) 664-3343
Mailing address
PO BOX 1562, OCEANA, WV 24870-1562
(304) 682-4586
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0005150
WV
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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