Individual
MARY KIRCHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2999 W SPENCER ST, SUITE 2060, GRAND CHUTE, WI 54914-4352
(920) 574-2272
Mailing address
2999 WEST SPENCER STREET, SUITE 2060, GRAND CHUTE, WI 54914
(920) 574-2272
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053708222
—
WI
Enumeration date
04/24/2015
Last updated
06/12/2015
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