Individual
ILA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
53585 NOKOMIS ROAD, ASHLAND, WI 54806
(715) 682-8518
Mailing address
53585 NOKOMIS ROAD, ASHLAND, WI 54806-4272
(715) 682-8518
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
11652
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11652-040
STATE LICENSE
WI
Enumeration date
12/22/2011
Last updated
12/22/2011
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