Individual
SCOTT WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2700 GRANDVIEW BLVD, WAUKESHA, WI 53188-1611
(262) 542-2003
Mailing address
2700 GRANDVIEW BLVD, WAUKESHA, WI 53188-1611
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15201-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33058200
—
WI
Enumeration date
11/10/2011
Last updated
11/10/2011
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