Individual
MICHAEL A WILCZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1104 S 25TH ST, BETHANY, MO 64424-2612
(660) 425-8171
(660) 425-8161
Mailing address
1104 S 25TH ST, BETHANY, MO 64424-2612
(660) 425-8171
(660) 425-8161
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
041144
MO
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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