NPI 1033509500

Dona Marie Idt, CPHT

Practitioner Pharmacy Technician Grafton, WI

Practice location

Address: 1250 N Port Washington Rd, Grafton, WI 53024-9315
Phone: (262) 375-6738
Fax: (262) 618-9138

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence 590107010293680 (WI)

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Registry record

NPI: 1033509500
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Feb 2015
Record last updated: 4 Feb 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.