Individual
SAMANTHA LYNN LENZENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
999 E MAIN ST, WAUPUN, WI 53963-2210
(920) 324-4696
(920) 324-4910
Mailing address
999 E MAIN ST, WAUPUN, WI 53963-2210
(920) 324-4696
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18616-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
361924025
WALGREENS
WI
Enumeration date
04/03/2020
Last updated
12/26/2022
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