Individual
GAGE WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
226 E PERKINS AVE, SANDUSKY, OH 44870-4905
(419) 239-2624
Mailing address
1155 JACKSON ST, VERMILION, OH 44089-1073
(440) 984-1078
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
03438706
OH
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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