Individual
MARY VANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3711 S TAYLOR DR, SHEBOYGAN, WI 53081-8495
(920) 459-8601
Mailing address
1257 KAUFMANN AVE, SHEBOYGAN, WI 53081-7618
(715) 302-2433
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21468-40
WI
1835C0205X
Critical Care Pharmacist
21468-40
WI
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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