Individual
MARIAM MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
N51W24953 LISBON RD, PEWAUKEE, WI 53072-1403
(262) 932-2500
Mailing address
N51W24953 LISBON RD, PEWAUKEE, WI 53072-1403
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21546-40
WI
Other
Enumeration date
04/15/2025
Last updated
11/30/2025
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