Individual
DANIEL WACKERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
960 BACKSTAGE LN, LAKE BUENA VISTA, FL 32830
(407) 934-2030
(407) 934-2031
Mailing address
960 BACKSTAGE LN, LAKE BUENA VISTA, FL 32830
(407) 934-2030
(407) 934-2031
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS35907
FL
Other
Enumeration date
01/03/2012
Last updated
01/03/2012
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