NPI 1033246152

Kenosha Vascular Lab INC

Organisation Specialist Kenosha, WI

Practice location

Address: 6308 8th Ave Suite 301, Kenosha, WI 53143-5031
Phone: (262) 656-8265
Fax: (262) 656-8273

Authorised official

Name: Robert G Cook
Title: President
Phone: (262) 656-8265

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 22193 (WI)

Other Specialist providers in Wisconsin →

Registry record

NPI: 1033246152
Entity type: Organization
NPI issued: 27 Feb 2007
Record last updated: 22 Aug 2020

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.