Individual
MR. JASON WETTENGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2015 SHAWANO AVE, GREEN BAY, WI 54303-2606
(920) 496-8110
(920) 496-8165
Mailing address
2015 SHAWANO AVE, GREEN BAY, WI 54303-2606
(920) 496-8110
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17697-40
WI
Other
Enumeration date
02/16/2015
Last updated
04/30/2017
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