Most Relevant Information
Provider Data
| NPI Number: | 1003449646 |
| Provider Name: | KELLY BAKIC |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 18799-40 |
Most Important Dates
| Enumeration Date: | 02/21/2020 |
| Last Updated: | 02/21/2020 |
Provider Practice Location
N56W15501 SILVER SPRING DR
MENOMONEE FALLS
WI
530515971
Practice Location Phone/Fax
| Phone: | 2627039781 |
| Fax: |
Provider Mailing Location
N56W15501 SILVER SPRING DR
MENOMONEE FALLS
WI
530515971
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |