Individual
KIM MARIE KUMMROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SFA-C
Contact information
Practice address
9000 W WISCONSIN AVE STE 360, MILWAUKEE, WI 53226-4874
(414) 337-7300
Mailing address
W340N6697 TIMBERLINE RD, OCONOMOWOC, WI 53066-5151
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
11/11/2019
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