Provider Demographics
NPI:1700401338
Name:ADAMSKI, JOANNA MARTYNA (RPH)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MARTYNA
Last Name:ADAMSKI
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 1:123 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:MAUSTON
Mailing Address - State:WI
Mailing Address - Zip Code:53948-1344
Mailing Address - Country:US
Mailing Address - Phone:608-847-5949
Mailing Address - Fax:608-847-5199
Practice Address - Street 1:123 E STATE ST
Practice Address - Street 2:
Practice Address - City:MAUSTON
Practice Address - State:WI
Practice Address - Zip Code:53948-1344
Practice Address - Country:US
Practice Address - Phone:608-847-5949
Practice Address - Fax:608-847-5199
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19946-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist