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General NPI Number Information
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NPI Number | 1285310243
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Entity Type | Individual
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Provider Name | ANDREW ZUEHLKE
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Gender | Male
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 301 W MAIN ST
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City | WATERTOWN
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State | WI
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Zip | 53094
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Country | US
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Telephone | 920-206-9588
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Fax |
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Provider Business Mailing Address
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Address Line | W5818 COUNTY ROAD CW
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City | WATERTOWN
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State | WI
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Zip | 53098
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Country | US
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Telephone | 920-248-9684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22175-40
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License Number State | WI
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