Individual
MARK RADTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
N65W24838 MAIN ST, SUSSEX, WI 53089-2670
(262) 820-0200
Mailing address
N65W24838 MAIN ST, SUSSEX, WI 53089-2670
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11872-040
WI
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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