Provider Demographics
NPI:1073605028
Name:KASER, JOHN WILSON (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILSON
Last Name:KASER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 BROWNING AVE
Mailing Address - Street 2:
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660
Mailing Address - Country:US
Mailing Address - Phone:231-723-5320
Mailing Address - Fax:
Practice Address - Street 1:401 RIVER ST WEST
Practice Address - Street 2:
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660
Practice Address - Country:US
Practice Address - Phone:231-723-2586
Practice Address - Fax:231-723-6180
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI21099183500000X
WI9637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist