Individual
DR. DEANJ DAVID WILLSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5000 L ST, OMAHA, NE 68117-1329
(402) 733-6935
Mailing address
15947 YATES ST, OMAHA, NE 68116-2435
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11812
NE
Other
Enumeration date
02/27/2010
Last updated
02/27/2010
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