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1407914146
WAYNE CLARK CHEATUM
LACKLAND AFB, TX
NPI
1407914146
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: FL PS19080)
Enumeration Date
2006-12-05
Last Update Date
2007-07-08
Business Address
Mr. WAYNE CLARK CHEATUM R. Ph.
2200 BERGQUIST DR SUITE 1 59 MDTS PHARMACY
LACKLAND AFB, TX 78236-9908
Phone number: 210-292-7216
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Mailing Address
Mr. WAYNE CLARK CHEATUM R. Ph.
13027 WILD HEART
HELOTES, TX 78023-3968
Phone number: 210-265-5036
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