Individual
BENJAMIN MATTHEW LILLEBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 RICHMOND WAY, NEW RICHMOND, WI 54017-6829
(715) 246-9097
Mailing address
659 SHORT ST, SAINT PAUL, MN 55106-6221
(763) 447-7276
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21489-40
WI
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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