Provider Demographics
NPI:1356981260
Name:WILLOZ, LEAH (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:WILLOZ
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 1:25750 GOLDEN POND LN SE
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:IA
Mailing Address - Zip Code:52755-2200
Mailing Address - Country:US
Mailing Address - Phone:319-321-3180
Mailing Address - Fax:
Practice Address - Street 1:510 E 6TH ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-4227
Practice Address - Country:US
Practice Address - Phone:563-263-1852
Practice Address - Fax:563-263-4005
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist