Individual
JOHN E DOCTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
19000 W NORTH AVE, BROOKFIELD, WI 53045-4106
(262) 785-2000
Mailing address
1750 MIRRO DR, MANITOWOC, WI 54220-6712
(920) 682-4803
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
30408-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43305200
—
WI
Enumeration date
06/10/2008
Last updated
06/10/2008
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