Individual
MR. KENNETH D SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2511 GREEN BAY ST, LA CROSSE, WI 54601-5900
(608) 775-8585
Mailing address
1325 MISSISSIPPI DR, DAKOTA, MN 55925-7171
(507) 643-6677
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
114107
MN
183500000X
Pharmacist
Primary
9813-40
WI
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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