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Other Service Providers Medical Genetics, Ph.D. Medical Genetics

Provider NPI: 1871646901

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 414-649-7825  Fax: --

Business Mailing Address:
W176S8582 NATURE CT  MUSKEGO, WI 53150-8599 US
Tel: 262-679-4502  Fax: --

NPI Information:
NPI: 1871646901
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y170100000XOther Service Providers
Medical Genetics, Ph.D. Medical Genetics

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 170100000X





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