Individual
MR. PAUL BYRON ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5104 CORTLAND AVE, RACINE, WI 53406
(262) 886-6403
Mailing address
5104 CORTLAND AVE, RACINE, WI 53406
(262) 886-6403
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11106-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11106-40
PHARMACIST LICENSE NUMBER
WI
Enumeration date
11/28/2011
Last updated
11/28/2011
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