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Search › Wisconsin › 183500000X

Michael Micksch, RPH

NPI 1730421710 · on the registry since 2013 · sole proprietor

Practice

Address
1010 W Ryan St
Brillion, WI 54110
Phone
(920) 756-2640
Fax
(920) 756-9262
Organisation at this address
Shopko Stores Operating Co Llc
Shopko Stores Operating Co Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
183500000X
183500000X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2013-03-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin