Individual
MR. MARK ALAN WYNTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
2225 W MARKET ST, BLOOMINGTON, IL 61705-5014
(309) 828-8626
Mailing address
417 GREENBRIAR DR APT 3, NORMAL, IL 61761-2232
(573) 462-0810
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049274552
IL
183700000X
Pharmacy Technician
67034956A
IN
Other
Enumeration date
01/30/2021
Last updated
09/28/2021
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