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Kenneth D Simon

Pharmacist in La Crosse, WI. Individual provider (NPI-1).

NPI number1497008239
StatusActive
Last updated in NPPESOct 17, 2012

Details

NPI
1497008239
Entity type
Individual (NPI-1)
Name
Mr. Kenneth D Simon
Sex
Male
Sole proprietor
No
Enumeration date
Oct 17, 2012
Last updated
Oct 17, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist9813-40WIYes
183500000X Pharmacist114107MN

Practice location

2511 Green Bay St
La Crosse, WI 54601-5900

Phone 608-775-8585

Mailing address

1325 Mississippi Dr
Dakota, MN 55925-7171

Phone 507-643-6677

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