Individual
HALEY KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1071 CY AVE, CASPER, WY 82604-3515
(307) 234-9379
Mailing address
1071 CY AVE, CASPER, WY 82604-3515
(307) 234-9379
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4069
WY
Other
Enumeration date
07/23/2018
Last updated
12/11/2020
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