Individual
MRS. MARY JO BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 SUMMIT AVE, OCONOMOWOC, WI 53066-4457
(262) 567-9173
(262) 567-3034
Mailing address
1021 SUMMIT AVE, OCONOMOWOC, WI 53066-4457
(262) 567-9173
(262) 567-3034
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
08261-040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08261-040
LICENSE NUMBER
WI
Enumeration date
11/11/2011
Last updated
11/11/2011
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