Provider Demographics
NPI:1063847754
Name:EISENZIMER, ALLISON KATHERINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:KATHERINE
Last Name:EISENZIMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:KATHERINE
Other - Last Name:KLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2611 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-3759
Mailing Address - Country:US
Mailing Address - Phone:406-782-5471
Mailing Address - Fax:
Practice Address - Street 1:2611 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-3759
Practice Address - Country:US
Practice Address - Phone:406-782-5471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT18796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist