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Individual

DR. DANE LEIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2206 WASHINGTON ST, TWO RIVERS, WI 54241-2241
(920) 793-8352
Mailing address
2206 WASHINGTON ST, TWO RIVERS, WI 54241-2241
(920) 793-8352

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16249-040
WI

Other

Enumeration date
12/12/2011
Last updated
08/19/2015
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