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General NPI Number Information
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NPI Number | 1710173141
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Entity Type | Individual
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Provider Name | RICHARD J KALLIO R.PH.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 580 N WASHINGTON ST SUITE 300
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City | JANESVILLE
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State | WI
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Zip | 53548-2984
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Country | US
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Telephone | 608-755-3599
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Fax | 608-755-3553
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Provider Business Mailing Address
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Address Line | 580 N WASHINGTON ST SUITE 300
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City | JANESVILLE
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State | WI
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Zip | 53548-2984
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Country | US
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Telephone | 608-755-3599
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Fax | 608-755-3553
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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 | 9120-040
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License Number State | WI
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