NPI 1306387337

John Mooney, CPO

Practitioner Prosthetist Glendale, WI

Practice location

Address: 2555 W Kenboern Dr, Glendale, WI 53209-1835
Phone: (414) 540-1202

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1306387337
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Mar 2017
Record last updated: 9 Mar 2017

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.