Individual
MATTHEW EUGENE BANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6901 W EDGERTON AVE, MILWAUKEE, WI 53220-4420
(414) 421-8401
(414) 855-0748
Mailing address
6901 W EDGERTON AVE, MILWAUKEE, WI 53220-4420
(414) 421-8401
(414) 855-0748
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
033.0130667
VT
183500000X
Pharmacist
1-106313
KS
183500000X
Pharmacist
14885
NE
183500000X
Pharmacist
Primary
16320
WI
183500000X
Pharmacist
16880
OK
183500000X
Pharmacist
17697
AL
183500000X
Pharmacist
23906
MD
183500000X
Pharmacist
5302043341
MI
183500000X
Pharmacist
59136
TX
183500000X
Pharmacist
PH236166
MA
183500000X
Pharmacist
PST.021720
LA
183500000X
Pharmacist
RP0008529
WV
183500000X
Pharmacist
T-15141
MS
Other
Enumeration date
01/16/2020
Last updated
01/18/2020
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