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COLETTE A. PROBASCO

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1356940845

Individual Registrant:
 COLETTE A. PROBASCO 
Gender: F
Sole Proprietor

Location and contact information for practice:
N1021 BLUES LN  HORTONVILLE, WI 54944-9265 US
Tel: 715-584-6827  Fax: --

Contact information for business:
N1021 BLUES LN  HORTONVILLE, WI 54944-9265 US
Tel: 715-584-6827  Fax: --

Registration Information:
NPI: 1356940845
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
WI10431

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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