Individual
MRS. LISA LOUISE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3909 MORMON COULEE RD, LA CROSSE, WI 54601-7965
(608) 788-9700
Mailing address
3909 MORMON COULEE RD, LA CROSSE, WI 54601-7965
(608) 784-5302
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10604-40
WI
183500000X
Pharmacist
4357
SD
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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