Individual
MR. MATTHEW LEE BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 672-6183
(262) 619-0499
Mailing address
34226 VENICE PARK RD, DELAFIELD, WI 53018-1323
(262) 434-0033
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051-037143
IL
183500000X
Pharmacist
Primary
14075-040
WI
183500000X
Pharmacist
5302028240
MI
Other
Enumeration date
11/16/2011
Last updated
04/26/2017
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