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SAMANTHA LYNN LENZENDORF

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1386273159

Individual Registrant:
 SAMANTHA LYNN LENZENDORF 
Gender: F
Sole Proprietor

Location and contact information for practice:
N7121 NEWVILLE RD  WATERLOO, WI 53594-9534 US
Tel: 847-778-6529  Fax: --

Contact information for business:
N7121 NEWVILLE RD  WATERLOO, WI 53594-9534 US
Tel: --  Fax: --

Registration Information:
NPI: 1386273159
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
WI18616-40

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
WALGREENS361924025WI01




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