Individual
HEIDI WENTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 WEST AVE S, LA CROSSE, WI 54601-4729
(608) 796-2058
(608) 796-2059
Mailing address
N6921 COUNTY ROAD M, HOLMEN, WI 54636-9131
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12149-040
WI
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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