Individual
MR. EARL J BANKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2011
Mailing address
824 BRIODY ST, BURLINGTON, WI 53105-1099
(262) 210-6573
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11859-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11859-40
—
WI
Enumeration date
05/29/2018
Last updated
05/29/2018
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