Individual
MARIE ROSE VISAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6950 W STATE ST, WAUWATOSA, WI 53213-2842
(414) 475-1932
Mailing address
6950 W STATE ST, WAUWATOSA, WI 53213-2842
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11200-40
WI
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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