Individual
MRS. JUSTINE JUDY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1211 E GREEN BAY ST, SHAWANO, WI 54166-2207
(715) 526-6551
Mailing address
1211 EAST GREEN BAY RD, SHAWANO, WI 54166-2207
(715) 526-6551
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051030602
IL
183500000X
Pharmacist
Primary
13761040
WI
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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