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General NPI Number Information
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NPI Number | 1962524710
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Entity Type | Individual
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Provider Name | STEPHEN FRANCIS WOLTANSKI RPH
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3001 WEST M20
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City | NEW ERA
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State | MI
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Zip | 49446
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Country | US
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Telephone | 231-861-6942
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 105
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City | NEW ERA
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State | MI
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Zip | 49446-0105
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Country | US
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Telephone | 231-894-6408
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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 | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 5302020252
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License Number State | MI
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