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1003897612
EDWARD LEWIS WYANT
MEDFORD, OR
NPI
1003897612
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OR 9432)
Enumeration Date
2005-11-10
Last Update Date
2007-07-08
Business Address
Mr. EDWARD LEWIS WYANT R.Ph
2825 E BARNETT RD
MEDFORD, OR 97504-8332
Phone number: 541-789-4251
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Mailing Address
Mr. EDWARD LEWIS WYANT R.Ph
8801 JOHN DAY DR
GOLD HILL, OR 97525-5525
Phone number: 541-855-7512
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