Individual
THOMAS HEIDELK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2304 E LINCOLNWAY, CHEYENNE, WY 82001-5416
(307) 635-0241
Mailing address
6740 FAITH DR UNIT C, CHEYENNE, WY 82009-2768
(402) 525-2689
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4213
WY
Other
Enumeration date
04/08/2020
Last updated
04/08/2020
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