Individual
LARISSA LYNN HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(507) 402-7160
Mailing address
2550 UNIVERSITY AVE APT 321, MADISON, WI 53705-3805
(507) 402-7160
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20962
WI
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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