Individual
BENJAMIN MODRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3237 S 16TH ST, MILWAUKEE, WI 53215-4526
(414) 647-5043
Mailing address
4727 162ND ST, URBANDALE, IA 50323-2542
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18899-40
WI
Other
Enumeration date
04/26/2020
Last updated
04/26/2020
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