Individual
STEPHEN WALLACE VAN DE WIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1425 E BUSINESS HIGHWAY 151, PLATTEVILLE, WI 53818-3842
(608) 348-6577
(608) 348-5909
Mailing address
1425 E BUSINESS HIGHWAY 151, PLATTEVILLE, WI 53818-3842
(608) 348-6577
(608) 348-5909
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9046-40
WI
Other
Enumeration date
04/05/2012
Last updated
04/05/2012
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