Individual
DR. KENNETH SCOTT NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
132 S. MAIN, LUCK PHARMACY INC, LUCK, WI 54853
(715) 472-2122
Mailing address
402 ROCK RIDGE TRL, MILLTOWN, WI 54858-4421
(715) 825-7979
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11412-040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33273100
—
WI
Enumeration date
05/08/2006
Last updated
07/08/2007
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