Individual
MARK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
709 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4719
(414) 481-8170
(414) 481-4258
Mailing address
709 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4719
(414) 481-8170
(414) 481-4258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8912-40
WI
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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