JERRY W WAYMIRE

POTEAU, OK
NPI1124344700
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: OK  9314)
Additional Taxonomies183500000X Pharmacist
(Licence: AR  6548)
Enumeration Date2010-04-08
Last Update Date2010-04-08
Business Address
-- JERRY W WAYMIRE DPH,PD
2219 N BROADWAY ST
POTEAU, OK 74953-2007
Phone number: 918-647-9531
Mailing Address
-- JERRY W WAYMIRE DPH,PD
2219 N BROADWAY AVE
POTEAU, OK 74953
Phone number: 918-647-9531
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