Individual
ERICH WYAN PONTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12279 LAKE UNDERHILL RD, ORLANDO, FL 32825-5010
(407) 273-0817
Mailing address
12279 LAKE UNDERHILL RD, ORLANDO, FL 32825-5010
(407) 273-0817
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT5681
FL
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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