Individual
KELLY SACKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3000
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.294952
IL
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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