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Individual

DR. JACOB THOMAS CANNESTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
21325 E MORELAND BLVD, WAUKESHA, WI 53186-2909
(262) 798-0223
Mailing address
1524 BIG BEND RD UNIT J, WAUKESHA, WI 53189-7660
(414) 581-2807

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22272-40
WI

Other

Enumeration date
08/07/2023
Last updated
08/07/2023
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