NPI 1144494238

Mark Rudolph Selle, RPH

Practitioner Pharmacist West Bend, WI

Practice location

Address: 5595 County Road Z Cedar Lake Campus Pharmacy, West Bend, WI 53095-9224
Phone: (262) 306-2140

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 9353-040 (WI)

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Registry record

NPI: 1144494238
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Apr 2008
Record last updated: 18 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.