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General NPI Number Information
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NPI Number | 1710211107
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Entity Type | Individual
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Provider Name | GRETCHEN KUNZE PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 2442 STATE RD
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City | LA CROSSE
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State | WI
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Zip | 54601-6155
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Country | US
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Telephone | 608-775-8877
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 7TH ST S #305
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City | LA CROSSE
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State | WI
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Zip | 54601-5405
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Country | US
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Telephone | 720-352-8015
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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 | 15341040
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18198
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License Number State | CO
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