Individual
JOSEPHINE ANN DIEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3825 DURAND AVE, RACINE, WI 53405-4424
(262) 554-8686
(262) 554-0744
Mailing address
3825 DURAND AVE, RACINE, WI 53405-4424
(262) 554-8686
(262) 554-0744
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11277
WI
Other
Enumeration date
11/19/2011
Last updated
11/19/2011
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