Individual
JAIME DEBARTOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1818 S RAPIDS RD, MANITOWOC, WI 54220-9375
(920) 663-3836
Mailing address
8217 60TH AVE, KENOSHA, WI 53142-1836
(262) 909-4024
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22403-40
WI
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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