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Individual

LOREN RAY CARRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
18601 LINCOLN ST, WHITEHALL, WI 54773-8605
(715) 538-4361
Mailing address
526 21ST AVE S, ONALASKA, WI 54650-8754
(218) 340-4177

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
14943
WI
1835P1200X
Pharmacotherapy Pharmacist
Primary
14943
WI

Other

Enumeration date
11/23/2012
Last updated
11/23/2012
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