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Organization
KENOSHA SURGICENTER LLC
Active
Organization
KENOSHA SURGICENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN EUGENE HOOKER (HR)
(262) 297-7246
Entity
Organization
Contact information
Practice address
10105 74TH ST STE 102, KENOSHA, WI 53142-7530
(262) 297-7246
(888) 701-0578
Mailing address
2500 W LAYTON AVE STE 120, MILWAUKEE, WI 53221-5400
(262) 297-7246
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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