Shiader Thao, RPH

NPI #1104422641 in Green Bay, Wisconsin

Provider Information

NPI Number: 1104422641
Entity Type: Individual
Name: Shiader Thao, RPH
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Dec 9, 2020
Last Updated: Dec 9, 2020

Practice Location

Address: 2440 W MASON ST
City: Green Bay
State: Wisconsin
ZIP Code: 54303-4711
Phone: (920) 499-2330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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