Individual
DR. LUCY WAGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
PO BOX 1203, MINOCQUA, WI 54548-1203
(847) 708-6893
Mailing address
PO BOX 1203, MINOCQUA, WI 54548-1203
(847) 708-6893
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
19760-40
WI
1835N1003X
Nutrition Support Pharmacist
Primary
19760-40
WI
202D00000X
Integrative Medicine Physician
19760-40
WI
Other
Enumeration date
10/04/2023
Last updated
04/16/2024
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