Individual
ROSE ANNETTE VAN DYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3649 S HASTINGS WAY, T-1774, EAU CLAIRE, WI 54701-8182
(715) 838-0447
Mailing address
3649 S HASTINGS WAY, T-1774, EAU CLAIRE, WI 54701-8182
(715) 838-0447
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
003887720
WI
183500000X
Pharmacist
0202207230
VA
183500000X
Pharmacist
051039400
IL
Other
Enumeration date
07/06/2011
Last updated
07/15/2015
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