NPI 1194291831

Glenn Martin Skattebo

Practitioner Driver Brown Deer, WI

Practice location

Address: 7684 N 51st St, Brown Deer, WI 53223-4353
Phone: (414) 430-5079

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence S310-2934-3090-03 (WI)

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Registry record

NPI: 1194291831
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Oct 2018
Record last updated: 21 Oct 2018

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.