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Individual

GERLYN M BRASIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
191 THEATER ROAD, ONALASKA, WI 54650-8679
(608) 392-5025
(608) 392-5788
Mailing address
191 THEATER ROAD, ONALASKA, WI 54650-8679
(608) 392-5025
(608) 392-5788

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44039
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34179100
WI
Enumeration date
09/13/2005
Last updated
01/24/2012
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