Individual
MR. DAVID KENNETH DICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S
Contact information
Practice address
3805 80TH ST, KENOSHA, WI 53142-4951
(262) 694-0750
Mailing address
3040 N SOUTHERN HILLS DR, WADSWORTH, IL 60083-9292
(847) 530-5268
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-034873
IL
183500000X
Pharmacist
12612-40
WI
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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