KENOSHA VASCULAR LAB INC NPI 1033246152

NPI Information

KENOSHA VASCULAR LAB INC is a specialist in Kenosha, WI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. KENOSHA VASCULAR LAB INC NPI is 1033246152. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6308 8TH AVE
SUITE 301
KENOSHA, WI
ZIP 53143-031
Phone: (262) 656-8265
Fax: (262) 656-8273

The provider's authorized official is Robert G Cook .
The authorized official title is President and has the following contact phone number (262) 656-8265.

The CLIA number assigned to this NPI record is 52D1024853 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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