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Individual

MR. DENNIS JOHN BALLWEG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
1200 PRAIRIE ST, PRAIRIE DU SAC, WI 53578-2041
(608) 643-6500
(608) 643-6533
Mailing address
S9002 WOODFORD LN, PRAIRIE DU SAC, WI 53578-9773
(608) 643-5108
(608) 643-6533

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11459
WI

Other

Enumeration date
10/24/2012
Last updated
10/24/2012
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