Individual
KOU VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15350 W BLUEMOUND RD, ELM GROVE, WI 53122-2307
(262) 789-6819
Mailing address
15350 W BLUEMOUND RD, ELM GROVE, WI 53122-2307
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19645-40
WI
Other
Enumeration date
03/01/2020
Last updated
03/01/2020
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