Individual
JASON LEE BISCHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1005 W COULTER AVE, POWELL, WY 82435-2530
(307) 754-2755
Mailing address
1005 W COULTER AVENUE, POWELL, WY 82435
(307) 754-2755
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3274
WY
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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