Individual
JOHN JOSEPH KMIECIAK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1145 N ALPINE RD, ROCKFORD, IL 61107-3613
(815) 398-2443
Mailing address
5729 JACKIES DR, LOVES PARK, IL 61111-3436
(779) 221-1149
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.305906
IL
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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