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1194017897
KELLY DIANE WAYNE
CHEYENNE, WY
NPI
1194017897
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: WY 2659)
Enumeration Date
2011-05-12
Last Update Date
2011-05-12
Business Address
Ms. KELLY DIANE WAYNE RPH
5353 YELLOWSTONE RD SUITE 310
CHEYENNE, WY 82009-4178
Phone number: 307-433-3704
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Mailing Address
Ms. KELLY DIANE WAYNE RPH
PO BOX 20330
CHEYENNE, WY 82003-7033
Phone number: 307-433-3704
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