Individual
JACK MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1262 S. CONWELL STC, CASPER, WY 82601
(303) 829-3800
Mailing address
1262 S. CONWELL STC, CASPER, WY 82601
(303) 829-3800
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
19267
CO
183500000X
Pharmacist
Primary
2395
WY
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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