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General NPI Number Information
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NPI Number | 1669480109
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Entity Type | Individual
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Provider Name | BRIAN G ROESLER R,PH.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 603 N BRIDGE STREET
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729
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Country | US
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Telephone | 715-723-9192
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Fax | 715-723-6463
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Provider Business Mailing Address
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Address Line | 616 MILES STREET
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729
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Country | US
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Telephone | 715-723-8349
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10209-040
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License Number State | WI
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