Individual
DR. SCOTT LEWIS FORTNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
901 MAIN AVE, DE PERE, WI 54115-1305
(920) 983-6153
(920) 983-6183
Mailing address
901 MAIN AVE, DE PERE, WI 54115-1305
(920) 983-6153
(920) 983-6183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13808-040
WI
Other
Enumeration date
07/13/2007
Last updated
01/05/2011
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