Provider Demographics
NPI:1881133205
Name:WOLSFELT, ELIZABETH ELLEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:WOLSFELT
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 1:320 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-2010
Mailing Address - Country:US
Mailing Address - Phone:406-283-6900
Mailing Address - Fax:406-293-6622
Practice Address - Street 1:320 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2010
Practice Address - Country:US
Practice Address - Phone:406-283-6900
Practice Address - Fax:406-293-6622
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT31504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist