Individual
JARED LONGLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
8500 W CAPITOL DR, MILWAUKEE, WI 53222-1869
(414) 463-1111
(414) 463-1112
Mailing address
1753 N HUMBOLDT AVE LOWR, MILWAUKEE, WI 53202-1664
(720) 737-9327
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18808-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18808-40
PHARMACIST LICENSE
WI
Enumeration date
11/28/2017
Last updated
03/17/2018
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