Individual
DAVID A VANDERTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
2500 OVERLOOK TER, PHARMACY, MADISON, WI 53705-2254
(608) 156-1901
Mailing address
838 TERRY PL, MADISON, WI 53711-1957
(608) 233-8177
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9312-040
WI
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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