Individual
KELLY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2259
Mailing address
W292N3972 FIELDING LN, PEWAUKEE, WI 53072-3160
(224) 330-9130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22352-40
WI
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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