Individual
JEREMY HAFIZ HUSAIN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
955 N MUTUAL WAY, APPLETON, WI 54913-8415
(920) 954-6400
Mailing address
1523 N DURKEE ST, APPLETON, WI 54911-3711
(608) 921-4265
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17936-40
WI
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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