Individual
DR. LAURA MARIE HANTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1709 S 18TH AVE, WEST BEND, WI 53095-7808
(262) 338-6444
(262) 338-3635
Mailing address
1709 S 18TH AVE, WEST BEND, WI 53095-7808
(262) 338-6444
(262) 338-3635
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16007
WI
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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