Individual
SHIADER THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2440 W MASON ST, GREEN BAY, WI 54303-4711
(920) 499-2330
Mailing address
2740 SAINT ANN DR, GREEN BAY, WI 54311-5886
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2520527
WI
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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