Individual
NICOLE HANOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
10725 W GREENFIELD AVE, WEST ALLIS, WI 53214-2446
(414) 258-8054
Mailing address
10725 W GREENFIELD AVE, WEST ALLIS, WI 53214-2446
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15720-40
WI
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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