Individual
MRS. MADONNA M WEIDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH,CDM
Contact information
Practice address
1706 N 16TH ST, COUNCIL BLUFFS, IA 51501-0121
(712) 322-3111
Mailing address
15321 PHEASANT DR, COUNCIL BLUFFS, IA 51503-5818
(712) 322-7573
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
11934
NE
183500000X
Pharmacist
Primary
15760
IA
Other
Enumeration date
03/25/2007
Last updated
07/08/2007
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