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Individual

ADAM WADE BROTHERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433, MADISON, WI 53792-0001
(608) 662-0817
Mailing address
2929 FISH HATCHERY RD APT 213, FITCHBURG, WI 53713-3161
(919) 608-3098

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14789-040
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14789-040
PHARMACIST
WI
01
PH00065697
PHARMACIST LICENSE NUMBER
WA
Enumeration date
11/21/2006
Last updated
07/08/2007
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