Most Relevant Information
Provider Data
| NPI Number: | 1003352030 |
| Provider Name: | KRISTI ROSE LIM WONG |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 74376 |
Most Important Dates
| Enumeration Date: | 01/14/2017 |
| Last Updated: | 01/14/2017 |
Provider Practice Location
401 KENILWORTH DR
PETALUMA
CA
949523400
Practice Location Phone/Fax
| Phone: | 7077756323 |
| Fax: | 7077756333 |
Provider Mailing Location
401 KENILWORTH DR
PETALUMA
CA
949523400
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |