Justin Ryan Mielke

NPI #1952678948 in Oshkosh, Wisconsin

Provider Information

NPI Number: 1952678948
Entity Type: Individual
Name: Justin Ryan Mielke
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 19, 2011
Last Updated: Nov 19, 2011

Practice Location

Address: 950 S KOELLER ST
City: Oshkosh
State: Wisconsin
ZIP Code: 54902-6175
Phone: (920) 303-1712

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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