Individual
KENNETH RUSSELL SCHAEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4202 MOUNTAIN LN, WAUSAU, WI 54401-8500
(715) 848-8748
Mailing address
4202 MOUNTAIN LN, WAUSAU, WI 54401-8500
(715) 848-8748
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7994040
WI
Other
Enumeration date
06/13/2006
Last updated
09/24/2008
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