Provider Demographics
NPI:1215330626
Name:TOLMAN, BRANDON WINTERS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:WINTERS
Last Name:TOLMAN
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 1:925 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GREYBULL
Mailing Address - State:WY
Mailing Address - Zip Code:82426-1610
Mailing Address - Country:US
Mailing Address - Phone:307-765-4601
Mailing Address - Fax:307-765-4600
Practice Address - Street 1:925 N 6TH ST
Practice Address - Street 2:
Practice Address - City:GREYBULL
Practice Address - State:WY
Practice Address - Zip Code:82426-1610
Practice Address - Country:US
Practice Address - Phone:307-765-4601
Practice Address - Fax:307-765-4600
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist