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Individual

ANDREW WASEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH.

Contact information

Practice address
1500 COSHOCTON AVE, MOUNT VERNON, OH 43050-1475
(740) 392-5152
(740) 392-1279
Mailing address
4520 SPORTSMAN CLUB RD, JOHNSTOWN, OH 43031-9461
(614) 578-9996

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03122351
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1861423824
NPI
Enumeration date
03/14/2010
Last updated
03/14/2010
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