Individual
DALE AUTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
3625 SOUTH COLLEGE ROAD, WILMINGTON, NC 28412
(910) 395-8248
Mailing address
3625 S COLLEGE RD, WILMINGTON, NC 28412-2003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16329
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06050000
—
NC
Enumeration date
10/04/2010
Last updated
10/04/2010
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