Individual
MR. KENNETH JAMES UEBELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
342 S WEBSTER AVE, GREEN BAY, WI 54301-3921
(920) 435-3002
(920) 884-0201
Mailing address
342 S WEBSTER AVE, GREEN BAY, WI 54301-3921
(920) 435-3002
(920) 884-0201
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
1337
WI
225100000X
Physical Therapist
Primary
1902
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41783500
—
WI
Enumeration date
12/23/2009
Last updated
12/23/2009
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