Organization
ENDEAVOR TESTING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN IRENE BLOCK (ADMINISTRATOR)
(262) 241-8892
Entity
Organization
Contact information
Practice address
11649 N PORT WASHINGTON RD, MEQUON, WI 53092-3460
(262) 241-8022
(262) 241-8047
Mailing address
11649 N PORT WASHINGTON RD, MEQUON, WI 53092-3460
(262) 241-8022
(262) 241-8047
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21278500
—
WI
Enumeration date
08/11/2005
Last updated
02/22/2019
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