Individual
LANCE BUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1244 E GREEN BAY ST, SHAWANO, WI 54166-2208
(715) 524-5983
Mailing address
1033 NORFIELD RD, SUAMICO, WI 54173-8529
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14743-40
WI
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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