Individual
MICHELLE MUGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2455 EASTERN AVE, PLYMOUTH, WI 53073-4240
(920) 893-5895
(920) 893-5898
Mailing address
2455 EASTERN AVE, PLYMOUTH, WI 53073-4240
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11353-40
WI
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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