Individual
MOLLIE JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3112 E GRAND AVE, LARAMIE, WY 82070-5141
(307) 742-7246
Mailing address
1607 MITCHELL ST, LARAMIE, WY 82072-2398
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3202
WY
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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