Provider Demographics
NPI:1477928646
Name:UNERTL, JANICE (RPH)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:UNERTL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-1300
Mailing Address - Country:US
Mailing Address - Phone:608-935-3661
Mailing Address - Fax:608-935-2661
Practice Address - Street 1:316 W SPRING ST
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1300
Practice Address - Country:US
Practice Address - Phone:608-935-3661
Practice Address - Fax:608-935-2661
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1330640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist