Individual
JASON SLAASTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4810 WASHINGTON AVE, RACINE, WI 53406-4220
(262) 635-0181
Mailing address
4810 WASHINGTON AVE, RACINE, WI 53406-4220
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18121-40
WI
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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