Individual
KAYLA DEITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2625 S 108TH ST, WEST ALLIS, WI 53227-1931
(414) 328-4051
Mailing address
2625 S 108TH ST, WEST ALLIS, WI 53227-1931
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18206-40
WI
Other
Enumeration date
12/18/2015
Last updated
03/01/2016
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