Provider First Line Business Practice Location Address:
1900 SOUTH AVENUE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PHARMACY, MAILSTOP LML-001
Provider Business Practice Location Address City Name:
LA CROSSE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-775-9492
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2024