Individual
LESLIE EIDEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
550 N HILLSIDE ST, WESLEY MED CENTER DEPT OF PHARMACY, WICHITA, KS 67214-4910
(316) 962-2305
Mailing address
419 W CONCORD RD, ANDOVER, KS 67002-8781
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10185
KS
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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