Individual
MARK R GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1000 EAST MOUNTAIN DRIVE, WILKES-BARRE, PA 18711
(570) 826-7707
Mailing address
1000 EAST MOUNTAIN DRIVE, WILKES-BARRE, PA 18711
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
RP043229L
PA
Other
Enumeration date
12/12/2008
Last updated
12/12/2008
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