Individual
MRS. AMANDA JANSSEN BORLESKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
732 FAIRVIEW TER, VERONA, WI 53593-1554
(608) 698-8873
Mailing address
732 FAIRVIEW TER, VERONA, WI 53593-1554
(608) 698-8873
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15221-40
WI
Other
Enumeration date
06/23/2008
Last updated
02/24/2011
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