| NPI | 1417156209 |
|---|---|
| Doing Business As | UVANTA PHARMACY OF LACROSSE |
| Entity Type | Organization |
| Authorized Contact | JEFF VANSTRATEN Owner 262-347-9405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WI 8750042) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2011-08-09 |