Individual
MS. DIANE MARIE KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
700 WEST AVE S, 1ST FLOOR, LA CROSSE, WI 54601-4783
(608) 785-1999
(608) 392-9727
Mailing address
3512 LEVY LN, LA CROSSE, WI 54601-6678
(608) 788-6006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
117343
MN
183500000X
Pharmacist
Primary
12881-040
WI
183500000X
Pharmacist
4373
SD
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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