Individual
DR. JOSE M CARRASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4016 TOWNE LAKES CIR, APT #7212, GRAND CHUTE, WI 54913-8006
(708) 990-9202
Mailing address
4016 TOWNE LAKES CIR, APT #7212, GRAND CHUTE, WI 54913-8006
(708) 990-9202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051296162
IL
183500000X
Pharmacist
Primary
16879-40
WI
Other
Enumeration date
08/30/2012
Last updated
09/01/2012
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