Provider Demographics
NPI:1588385470
Name:CHANDLER, RYAN GAIL (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:GAIL
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GATEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5782
Mailing Address - Country:US
Mailing Address - Phone:307-362-1967
Mailing Address - Fax:
Practice Address - Street 1:201 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5782
Practice Address - Country:US
Practice Address - Phone:307-362-1967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4420183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist