Individual
SARA MARIE KOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-1290
Mailing address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-1290
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17490-40
WI
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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