Provider Demographics
NPI:1932415783
Name:VANDERSLOOT, JOYCE DEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:DEE
Last Name:VANDERSLOOT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 GATEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5709
Mailing Address - Country:US
Mailing Address - Phone:307-382-2536
Mailing Address - Fax:307-382-9042
Practice Address - Street 1:70 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5709
Practice Address - Country:US
Practice Address - Phone:307-382-2536
Practice Address - Fax:307-382-9042
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3045183500000X
AZS014870183500000X
TX50036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist