Individual
MR. JERRY LEONARD GLOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
2442 STATE RD, LA CROSSE, WI 54601-6155
(608) 775-8571
(608) 775-8578
Mailing address
1119 PINE ST, ONALASKA, WI 54650-2029
(608) 519-1181
(608) 775-8578
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7975040
WI
Other
Enumeration date
01/21/2007
Last updated
09/08/2009
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