Individual
MR. JONATHAN WILLIAM STROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
744 SOUTH WEBSTER AVE, GREEN BAY, WI 54307-3400
(920) 431-5696
(920) 431-5677
Mailing address
2987 FLEETWOOD DR, GREEN BAY, WI 54313
(920) 431-9006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12561040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33233700
—
WI
01
—
5124689
NCPDP
—
Enumeration date
08/11/2006
Last updated
07/08/2007
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