Individual
MR. JEROME PAUL BOORTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
9366 STATE ROAD 16, ONALASKA, WI 54650-8526
(608) 781-5404
(608) 783-4966
Mailing address
9366 STATE HIGHWAY 16, ONALASKA, WI 54650
(608) 781-5404
(608) 783-4966
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9192
WI
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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