Individual
HEATHER RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4961 LONG BEACH RD SE STE 1, SOUTHPORT, NC 28461-8001
(910) 457-9566
Mailing address
6028 WAYFARER TRL, WILMINGTON, NC 28409-6006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25933
NC
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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