Organization
SUPPORTING PROVIDER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA BUFORD (VOCATIONAL REHABILITATION)
(262) 527-1282
Entity
Organization
Contact information
Practice address
8330 S WYNONA CT, OAK CREEK, WI 53154-2740
(262) 527-1282
Mailing address
8330 S WYNONA CT, OAK CREEK, WI 53154-2740
(262) 527-1282
Taxonomy
Speciality
Code
Description
License number
State
385HR2065X
Child Physical Disabilities Respite Care
Primary
—
—
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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