Individual
LUKE ASHTON WYCKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
304 LONG CREEK LN, HAMPTON, VA 23664-1923
(757) 651-5833
Mailing address
304 LONG CREEK LN, HAMPTON, VA 23664-1923
(757) 651-5833
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202215805
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202215805
VIRGINIA BOARD OF PHARMACY
VA
Enumeration date
01/08/2019
Last updated
01/08/2019
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