Individual
KEVIN SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1717 MILTON AVE, JANESVILLE, WI 53545-0884
(608) 754-2278
Mailing address
1717 MILTON AVE, JANESVILLE, WI 53545-0884
(608) 754-2278
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20619
WI
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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