Individual
GERALD WIELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
2757 NW STEWART PKWY, ROSEBURG, OR 97471-1251
(541) 957-0157
Mailing address
909 NW BROADWAY ST, ROSEBURG, OR 97471-2230
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0009998
OR
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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