Individual
JASON RASOUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12601 W HAMPTON AVE, BUTLER, WI 53007-1730
(262) 781-0148
Mailing address
12601 W HAMPTON AVE, BUTLER, WI 53007-1730
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15029-040
WI
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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