Provider Demographics
NPI:1811281744
Name:WANZER, KARI MICHELLE (RPH)
Entity type:Individual
Prefix:MRS
First Name:KARI
Middle Name:MICHELLE
Last Name:WANZER
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 1:1980 LINCOLN WAY E
Mailing Address - Street 2:T-2044
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-6965
Mailing Address - Country:US
Mailing Address - Phone:330-833-4151
Mailing Address - Fax:
Practice Address - Street 1:1980 LINCOLN WAY E
Practice Address - Street 2:T-2044
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-6965
Practice Address - Country:US
Practice Address - Phone:330-833-4151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist