Individual
MS. DONA MARIE IDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1250 N PORT WASHINGTON RD, GRAFTON, WI 53024-9315
(262) 375-6738
(262) 618-9138
Mailing address
1250 N PORT WASHINGTON RD, GRAFTON, WI 53024-9315
(262) 375-6738
(262) 618-9138
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
590107010293680
WI
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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