Individual
ALANNAH L WALLSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
999 E MAIN ST, WAUPUN, WI 53963-2210
(920) 324-4696
Mailing address
999 E MAIN ST, WAUPUN, WI 53963-2210
(920) 324-4696
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20036-40
WI
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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