Individual
MELANIE SUE WILDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2360 HIGHWAY 95, BULLHEAD CITY, AZ 86442-7303
(928) 763-5858
(928) 763-0972
Mailing address
2360 HIGHWAY 95, BULLHEAD CITY, AZ 86442-7303
(928) 763-5858
(928) 763-0972
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S016015
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S016015
STATE LICENSE
AZ
Enumeration date
08/10/2010
Last updated
08/10/2010
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