Individual
KELLAN BRETT KLUBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11040 N STATE RD 77, HAYWARD, WI 54843
(715) 934-4910
Mailing address
11040 N STATE RD 77, HAYWARD, WI 54843
(715) 934-4910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
84153-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2021
Last updated
09/11/2024
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