Individual
DAVID JAMESON BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
580 LIVINGSTON AVE, CHEYENNE, WY 82007-1966
(307) 823-6812
(307) 823-6813
Mailing address
670 1/2 N 11TH ST, LARAMIE, WY 82072-2740
(562) 309-5670
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4652
WY
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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