Individual
KIMBERLY MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11220 W BURLEIGH ST, WAUWATOSA, WI 53222-3214
(414) 810-3288
Mailing address
11220 W BURLEIGH ST, WAUWATOSA, WI 53222-3214
(414) 810-3288
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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