Individual
WYATT PENFOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
407 S MEDICAL ARTS CT STE A, GILLETTE, WY 82716-3372
(307) 685-2899
Mailing address
407 S MEDICAL ARTS CT STE A, GILLETTE, WY 82716-3372
(307) 685-2899
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4296
WY
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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