Individual
DEMI CHAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2656 N WAUWATOSA AVE, WAUWATOSA, WI 53213-1137
(224) 355-0507
Mailing address
2656 N WAUWATOSA AVE, WAUWATOSA, WI 53213-1137
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20561-40
WI
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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