Individual
MR. MICHAEL W WIXOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
15481 COMMERCIAL RD, LAKEWOOD, WI 54138-9677
(715) 276-3646
(715) 276-9568
Mailing address
15481 COMMERCIAL RD, LAKEWOOD, WI 54138-9677
(715) 276-3646
(715) 276-9568
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12282040
WI
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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