Individual
MARY ANNE STREAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2677 S 108TH ST, WEST ALLIS, WI 53227-1925
(414) 545-1440
Mailing address
2103 SPRINGBROOK S, SOUTH, WAUKESHA, WI 53186-1225
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15159-40
WI
Other
Enumeration date
12/11/2011
Last updated
12/11/2011
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