Individual
MRS. MARY R WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
3001 OAK GROVE RD, POPLAR BLUFF, MO 63901-8942
(573) 772-7169
Mailing address
2601 WOODSTONE DR, POPLAR BLUFF, MO 63901-2561
(573) 718-7573
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2022032015
MO
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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