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Individual

SCOTT MICHAEL FARRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPHARM

Contact information

Practice address
607 PARK AVE, BEAVER DAM, WI 53916-2201
(920) 356-0148
(920) 356-0401
Mailing address
607 PARK AVE, BEAVER DAM, WI 53916-2201
(920) 356-0148
(920) 346-0401

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14293-040
WI

Other

Enumeration date
10/19/2011
Last updated
10/19/2011
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