Kelly Wiese

NPI #1265889976 in New Lenox, Illinois

Provider Information

NPI Number
1265889976
Entity Type
Individual
Name
Kelly Wiese
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Pharmacist
Enumeration Date
May 23, 2016
Last Updated
May 23, 2016

Practice Location

Address
2021 E LARAWAY RD
ZIP Code
60451-9507
Phone
(815) 463-4954

Specialties & Taxonomy Codes

Specialty
Pharmacist

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