Individual
MR. DALE WARREN VAN WIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
544 N. THIRD ST, PHARMACY, LARAMIE, WY 82070
(307) 745-4224
Mailing address
256 SUNDANCE LN, APT. 516, LARAMIE, WY 82072-8717
(307) 766-4546
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
044929
MO
183500000X
Pharmacist
Primary
3619TL
WY
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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