Individual
BONNY KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5152 ANTON DR, 213, FITCHBURG, WI 53719-1772
(608) 217-4551
Mailing address
5152 ANTON DR, 213, FITCHBURG, WI 53719-1772
(608) 217-4551
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14533-040
WI
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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