| Athlete Pharmacist Llc | |
|
211 Nautilus Dr Apt 8 Madison WI 53705-4358 | |
| (414) 207-0309 | |
| Not Available |
| Full Name | Athlete Pharmacist Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 211 Nautilus Dr Apt 8, Madison, Wisconsin |
| Authorized Official Name and Position | Mark V Lorson (CEO) |
| Authorized Official Contact | 4142070309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Athlete Pharmacist Llc 211 Nautilus Dr Apt 8 Madison WI 53705-4358 Ph: (414) 207-0309 | Athlete Pharmacist Llc 211 Nautilus Dr Apt 8 Madison WI 53705-4358 Ph: (414) 207-0309 |
| NPI Number | 1649520008 |
|---|---|
| Provider Enumeration Date | 09/13/2012 |
| Last Update Date | 09/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649520008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Secondary |
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