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Individual

KOKUGONZA KAIJAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7401 W GOOD HOPE RD, MILWAUKEE, WI 53223-4618
(414) 760-3273
Mailing address
7401 W GOOD HOPE RD, MILWAUKEE, WI 53223-4618
(414) 760-3273

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16553-40
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16553-40
PHARMACIST LICENSE
WI
Enumeration date
12/08/2014
Last updated
12/08/2014
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