Organization
KETTLE MORAINE YMCA, INC. YOUNG MEN'S CHRISTIAN ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROB JOHNSON (EXECUTIVE DIRECTOR)
(262) 247-1006
Entity
Organization
Contact information
Practice address
1111 W WASHINGTON ST, WEST BEND, WI 53095-2433
(262) 334-3405
(262) 334-5414
Mailing address
1111 W WASHINGTON ST, WEST BEND, WI 53095-2433
(262) 334-3405
(262) 334-5414
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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