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Individual

MR. HOWARD JOHN MIZE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
639 S MAIN ST, SUITE 101, DE FOREST, WI 53532-1478
(608) 846-2712
Mailing address
3745 SEQUIOA TRAIL, VERONA, WI 53593
(608) 798-1315

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8946-040
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33266000
WI
Enumeration date
10/04/2006
Last updated
07/08/2007
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