Individual
MS. MARILYN MARY MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 HIGHWAY FIFTY ONE, STOUGHTON, WI 53589
(608) 873-7612
(608) 873-7894
Mailing address
1705 HIGHWAY 51, STOUGHTON, WI 53589
(608) 873-7612
(608) 873-7894
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14888-040
WI
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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