Individual
JOE XAYPHARATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2320 W RYAN RD, OAK CREEK, WI 53154-4325
(414) 761-1692
Mailing address
2320 W RYAN RD, OAK CREEK, WI 53154-4325
(414) 761-1692
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17749-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17749-40
PHARMACIST LICENSE
WI
Enumeration date
03/14/2017
Last updated
03/14/2017
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