JACOB HENRICKSEN

KENOSHA, WI
NPI1265037188
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: WI  20472-40)
Enumeration Date2020-11-30
Last Update Date2020-11-30
Business Address
JACOB HENRICKSEN PharmD
3726 22ND AVE
KENOSHA, WI 53140-5300
Phone number: 262-654-6545
Mailing Address
JACOB HENRICKSEN PharmD
11221 SYNERGY DR APT 366
WAUWATOSA, WI 53222-1351
Phone number: 763-202-9618
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