Individual
CHRISTINE A. WISKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
535 E BROADWAY, COUNCIL BLUFFS, IA 51503-4419
(712) 329-0930
Mailing address
18 RIDGE DR W, COUNCIL BLUFFS, IA 51503-0372
(402) 850-7159
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14546
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14546
PHARMACY LICENSE
IA
Enumeration date
02/08/2012
Last updated
02/08/2012
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