Individual
MS. KELLY DIANE WAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
5353 YELLOWSTONE RD, SUITE 310, CHEYENNE, WY 82009-4178
(307) 433-3704
(303) 370-1690
Mailing address
PO BOX 20330, CHEYENNE, WY 82003-7033
(307) 433-3704
(303) 370-1690
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2659
WY
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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