Individual
DR. JEREMY JON ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1500 WASHINGTON ST, TWO RIVERS, WI 54241-3045
(920) 794-1225
Mailing address
412 MABEL ST, DE FOREST, WI 53532-1215
(608) 212-6984
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16836-40
WI
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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