Individual
EDWARD CLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 63RD ST, KENOSHA, WI 53143-4467
(262) 653-1202
(262) 564-8840
Mailing address
1901 63RD ST, KENOSHA, WI 53143-4467
(262) 653-1202
(262) 564-8840
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13857-40
WI
Other
Enumeration date
11/15/2014
Last updated
11/15/2014
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