Individual
MICHAEL TODD ZAGELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
102 S MAIN ST, FORT ATKINSON, WI 53538-2014
(920) 563-2458
(920) 563-2792
Mailing address
102 S MAIN ST, FORT ATKINSON, WI 53538-2014
(920) 563-2458
(920) 563-2792
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14297-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033054500
—
WI
Enumeration date
11/22/2019
Last updated
11/22/2019
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