Individual
KELLIE DOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11558 N PORT WASHINGTON RD, MEQUON, WI 53092-3416
(262) 241-7983
Mailing address
11558 N PORT WASHINGTON RD, MEQUON, WI 53092-3416
(262) 241-7983
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14503-40
WI
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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