Individual
PAUL BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 BUFFALO WAY, JACKSON, WY 83001
(307) 733-9223
Mailing address
105 BUFFALO WAY, JACKSON, WY 83001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2202
WY
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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