Individual
PENNY WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
976 COMMONWEALTH BLVD, MARTINSVILLE, VA 24112-1887
(276) 638-2905
Mailing address
1005 RIVER FOREST PL, MARTINSVILLE, VA 24112-5515
(276) 638-3780
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202006386
VA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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