Individual
DR. JUSTIN COLE WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH, MED
Contact information
Practice address
PO BOX 877805, TEMPE, AZ 85287-7805
(865) 680-6494
Mailing address
PO BOX 877805, TEMPE, AZ 85287-7805
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
68763
TX
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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