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Organization
MMS
Active
Organization
MMS
Active
Other names
Mobile Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J RUSSELL NP (OWNER)
(262) 939-4744
Entity
Organization
Contact information
Practice address
6114 7TH AVE, KENOSHA, WI 53143-4538
(262) 939-4744
Mailing address
6114 7TH AVE, KENOSHA, WI 53143-4538
(262) 939-4744
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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