DAVID KENNETH DICKS

KENOSHA, WI
NPI1306122783
Professional NameDAVID KENNETH DICKS
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: IL  051-034873)
Additional Taxonomies183500000X Pharmacist
(Licence: WI  12612-40)
Enumeration Date2011-10-28
Last Update Date2011-10-28
Business Address
Mr. DAVID KENNETH DICKS B.S
3805 80TH ST
KENOSHA, WI 53142-4951
Phone number: 262-694-0750
Mailing Address
Mr. DAVID KENNETH DICKS B.S
3040 N SOUTHERN HILLS DR
WADSWORTH, IL 60083-9292
Phone number: 847-530-5268