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Individual

IVY MARIE CANNELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(218) 259-4849
Mailing address
2620 EAST AVE S, LA CROSSE, WI 54601-6713
(218) 259-4849

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21334-40
WI
183500000X
Pharmacist
2133440
WI

Other

Enumeration date
03/06/2023
Last updated
03/06/2023
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