Organization
TRINITY INTEGRATIVE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIE LOREE KOCOUREK M.D. (DIRECTOR/OWNER)
(414) 427-1577
Entity
Organization
Contact information
Practice address
15350 W NATIONAL AVE, SUITE 212, NEW BERLIN, WI 53151-5158
(262) 782-9541
(262) 782-6541
Mailing address
S72W13575 WOODS RD, MUSKEGO, WI 53150-3707
(414) 427-1577
(414) 427-1577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53754
WI
Other
Enumeration date
07/26/2011
Last updated
08/15/2011
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