Individual
KELLY M GLODOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY STE 101, MILWAUKEE, WI 53215
(414) 649-7710
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2756
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100021323
—
WI
Enumeration date
12/28/2011
Last updated
01/29/2024
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