Individual
GENA TRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 BAY PARK SQ, GREEN BAY, WI 54304-5104
(920) 499-5889
(920) 499-3718
Mailing address
301 BAY PARK SQ, GREEN BAY, WI 54304-5104
(920) 499-5889
(920) 499-3718
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12386-040
WI
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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