Individual
JERRY KREIBICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
W25551 US HIGHWAY 10, ELEVA, WI 54738-8962
(715) 287-2575
Mailing address
W25551 US HIGHWAY 10, ELEVA, WI 54738-8962
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1093817
WI
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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