Individual
NATHAN JOHN BERTUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1578 APPLETON RD, MENASHA, WI 54952-1104
(920) 722-1895
(920) 722-3195
Mailing address
1191 WESTOWNE DR, NEENAH, WI 54956-2176
(920) 725-3152
(920) 725-3238
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16571-40
WI
183500000X
Pharmacist
5302038799
MI
3336C0003X
Community/Retail Pharmacy
—
WI
Other
Enumeration date
11/08/2012
Last updated
02/27/2020
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