Individual
JOHN WIKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2004 W MARLER LN, OZARK, MO 65721-7661
(605) 595-1959
Mailing address
725 E ELEVEN POINT LN, NIXA, MO 65714-7931
(605) 595-1959
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
122425
MN
183500000X
Pharmacist
Primary
2017044638
MO
183500000X
Pharmacist
23217
IA
183500000X
Pharmacist
5667
SD
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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