Individual
AMANDA LEA WEGENKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1900 SOUTH AVE, H01-005, LA CROSSE, WI 54601-5467
(608) 775-3701
Mailing address
1836 SOUTH AVE # H01-005, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
119551
MN
183500000X
Pharmacist
Primary
15643-40
WI
183500000X
Pharmacist
20886
IA
Other
Enumeration date
10/06/2009
Last updated
02/07/2024
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