NPI 1053860908

Maris Miller, PHARMD

Practitioner Pharmacist Fond Du Lac, WI

Practice location

Address: 420 E Division St Pharmacy Plus, Fond Du Lac, WI 54935-4560
Phone: (920) 926-8585
Fax: (920) 926-8935

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 17718-40 (WI)

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Registry record

NPI: 1053860908
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Oct 2016
Record last updated: 3 Oct 2016

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.