Individual
DR. KEVIN ANDREW BANSE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
13111 N PORT WASHINGTON RD STE 116, MEQUON, WI 53097-2416
(262) 243-7367
Mailing address
13111 N PORT WASHINGTON RD STE 116, MEQUON, WI 53097-2416
(262) 243-7367
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
21399-40
WI
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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