Individual
ILYEEN KATHRYN WIESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
805 WALNUT RIDGE DR, WAUKEE, IA 50263-9619
(515) 224-0227
Mailing address
805 WALNUT RIDGE DR, WAUKEE, IA 50263-9619
(515) 224-0227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15737
IA
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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