Individual
KEVIN WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17345 CIVIC DR STE 1331, BROOKFIELD, WI 53045-5070
(262) 462-0216
Mailing address
17345 CIVIC DR STE 1331, BROOKFIELD, WI 53045-5070
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7060-226
WI
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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