Individual
GRACE S CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2275 N MAYFAIR RD, WAUWATOSA, WI 53226-2207
(414) 774-4821
Mailing address
2100 N MAYFAIR RD UNIT 203, WAUWATOSA, WI 53226-2228
(608) 770-8269
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20343
WI
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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