Individual
KLAIR DIEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3701 E CALUMET ST, APPLETON, WI 54915-4149
(920) 996-0746
Mailing address
2917 SOUTHBREEZE CT, KAUKAUNA, WI 54130-3587
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20393
WI
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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