Individual
MELISSA HAAKENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 W SUMMIT AVE, WALES, WI 53183-9436
(262) 968-6900
Mailing address
W358N6678 W SPRING HOLLOW CIR, OCONOMOWOC, WI 53066-6211
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14423
WI
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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