Leonard Bolog, R.PH.

NPI #1891096517 in Wasilla, Alaska

Provider Information

NPI Number: 1891096517
Entity Type: Individual
Name: Leonard Bolog, R.PH.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: R.PH.
Enumeration Date: Nov 11, 2010
Last Updated: Nov 11, 2010

Practice Location

Address: 595 E PARKS HWY # 300
City: Wasilla
State: Alaska
ZIP Code: 99654-8102
Phone: (907) 352-1160

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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