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Individual

KENNETH LEE O'NEILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2880 UNIVERSITY AVE, MC 9001, MADISON, WI 53705-3644
(608) 263-9393
Mailing address
97 OAK CREEK TRL, MADISON, WI 53717-1509
(608) 263-9393

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9788-040
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9788-040
PHARMACIST
WI
Enumeration date
11/09/2006
Last updated
07/08/2007
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