Individual
LISA WAKNITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2809 100TH ST, URBANDALE, IA 50322-3860
(515) 252-7688
Mailing address
15701 BOSTON PKWY, CLIVE, IA 50325-4622
(515) 987-9927
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
1744
IA
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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