Individual
ELLEN MARIE BERGENDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 TUTTLE ST, BARABOO, WI 53913-3319
(608) 355-3800
Mailing address
1700 TUTTLE ST, BARABOO, WI 53913-3319
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17922-40
WI
Other
Enumeration date
06/24/2015
Last updated
11/15/2024
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