Provider Demographics
NPI:1922375120
Name:TEMPLER, AMANDA J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:J
Last Name:TEMPLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LAKE SHORE DRIVE WEST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-1645
Mailing Address - Country:US
Mailing Address - Phone:715-685-0202
Mailing Address - Fax:715-685-0208
Practice Address - Street 1:110 LAKE SHORE DR W
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-1645
Practice Address - Country:US
Practice Address - Phone:715-685-0202
Practice Address - Fax:715-685-0208
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038160183500000X
WI16193-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist