| NPI | 1164592150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANNE WAWRZYN Pharmacy Manager 414-229-6643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WI 7046-042) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |