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Individual

MRS. JENNIFER LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
900 E MAIN ST, WATERFORD, WI 53185-4536
(262) 514-4290
Mailing address
904 E PEARSON ST, 304, MILWAUKEE, WI 53202-1594
(414) 403-7293

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15051-40
WI

Other

Enumeration date
10/06/2011
Last updated
10/06/2011
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