Individual
BRADLEY R. RIESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
707 14TH ST, PHARMACY, BARABOO, WI 53913-1539
(608) 356-1453
Mailing address
707 14TH ST, PHARMACY, BARABOO, WI 53913-1539
(608) 356-1453
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10547-40
WI
183500000X
Pharmacist
S017011
AZ
Other
Enumeration date
03/31/2013
Last updated
03/31/2013
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