Individual
DR. JASON LAWRENCE WALCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2360 E PERSHING BLVD # 119, CHEYENNE, WY 82001-5356
(307) 778-7550
Mailing address
2360 EAST PERSHING BLVD, PHARMACY 119, CHEYENNE, WY 82001
(307) 778-7550
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
054562
NY
1835G0303X
Geriatric Pharmacist
Primary
9103911
WY
Other
Enumeration date
07/14/2011
Last updated
01/16/2024
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