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Individual

AJISH ISAC PHILIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8218
Mailing address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8218

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051294197
IL
183500000X
Pharmacist
Primary
15670-40
WI

Other

Enumeration date
02/08/2025
Last updated
02/08/2025
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