Individual
MRS. MARY E JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT, WPQC CERTIFIED
Contact information
Practice address
405 WATER ST, PRAIRIE DU SAC, WI 53578-1126
(608) 643-3396
(608) 643-4361
Mailing address
405 WATER ST, PRAIRIE DU SAC, WI 53578-1126
(608) 643-3396
(608) 643-4361
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
330101051154461
WI
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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