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Organization

KENOSHA VASCULAR LAB INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT G COOK (PRESIDENT)
(262) 656-8265
Entity
Organization

Contact information

Practice address
6308 8TH AVE, SUITE 301, KENOSHA, WI 53143-5031
(262) 656-8265
(262) 656-8273
Mailing address
6308 8TH AVE, SUITE 301, KENOSHA, WI 53143-5031
(262) 656-8265
(262) 656-8273

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22193
WI

Other

Enumeration date
02/27/2007
Last updated
08/22/2020
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