Provider Demographics
NPI:1578783247
Name:VONSEGGERN, SUZANNE (RPH)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:VONSEGGERN
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 1:304 W 14TH ST S
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3531
Mailing Address - Country:US
Mailing Address - Phone:641-792-2808
Mailing Address - Fax:
Practice Address - Street 1:1610 VEMEER RD
Practice Address - Street 2:EAST PLANT 3
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219
Practice Address - Country:US
Practice Address - Phone:641-621-7470
Practice Address - Fax:641-621-7471
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist