Individual
MARK RUDOLPH SELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5595 COUNTY ROAD Z, CEDAR LAKE CAMPUS PHARMACY, WEST BEND, WI 53095-9224
(262) 306-2140
Mailing address
5595 COUNTY ROAD Z, CEDAR LAKE CAMPUS PHARMACY, WEST BEND, WI 53095-9224
(262) 306-2140
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9353-040
WI
Other
Enumeration date
04/18/2008
Last updated
10/18/2012
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