Individual
MR. MARK MENNICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3700 UNIVERSITY AVE, MADISON, WI 53705-2144
(608) 238-7109
(608) 238-1089
Mailing address
3700 UNIVERSITY AVE, MADISON, WI 53705-2144
(608) 238-7109
(608) 238-1089
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9989-40
WI
Other
Enumeration date
03/16/2015
Last updated
03/16/2015
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