Individual
ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 STATE ROAD 82, MAUSTON, WI 53948-1402
(608) 847-7814
Mailing address
403 STATE ROAD 82, MAUSTON, WI 53948-1402
(608) 847-7814
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15129-40
WI
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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