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Individual

MR. T. GREGG WATSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
3529 SUPERIOR AVE, SHEBOYGAN, WI 53081-1865
(920) 459-2755
Mailing address
1717 RIDGE RD, SHEBOYGAN, WI 53083-2146
(920) 459-8457

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10035-040
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10035-040
PHARMACIST LICENSE
WI
Enumeration date
11/16/2006
Last updated
07/08/2007
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