MADONNA M WEIDMAN

COUNCIL BLUFFS, IA
NPI1417074220
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: IA  15760)
Additional Taxonomies183500000X Pharmacist
(Licence: NE  11934)
Enumeration Date2007-03-25
Last Update Date2007-07-08
Business Address
Mrs. MADONNA M WEIDMAN RPH,CDM
1706 N 16TH ST
COUNCIL BLUFFS, IA 51501-0121
Phone number: 712-322-3111
Mailing Address
Mrs. MADONNA M WEIDMAN RPH,CDM
15321 PHEASANT DR
COUNCIL BLUFFS, IA 51503-5818
Phone number: 712-322-7573