Provider Demographics
NPI:1982356226
Name:SANOK, RYAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:SANOK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10489 STATE ROAD 27
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:WI
Mailing Address - Zip Code:54843-2000
Mailing Address - Country:US
Mailing Address - Phone:715-634-1919
Mailing Address - Fax:
Practice Address - Street 1:10489 STATE ROAD 27
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843-2000
Practice Address - Country:US
Practice Address - Phone:715-634-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21151-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist