Individual
MICHAEL KARL WYANT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2900 E BARNETT RD, STE 1, MEDFORD, OR 97504-8380
(541) 789-5850
Mailing address
7341 S FORK LITTLE BUTTE CR RD, EAGLE POINT, OR 97524-5541
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8563
OR
Other
Enumeration date
06/14/2005
Last updated
07/08/2007
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