Organization
CMWL2
Active
Organization
CMWL2
Active
Other names
Medi Weight Loss Appleton
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HERBERT S COUSSONS MD (OWNER)
(920) 338-6868
Entity
Organization
Contact information
Practice address
1688 N CASALOMA DR, APPLETON, WI 54913-8245
(920) 707-5100
Mailing address
2641 DEVELOPMENT DR, GREEN BAY, WI 54311-4240
(920) 338-6868
Taxonomy
Speciality
Code
Description
License number
State
207VB0002X
Obesity Medicine (Obstetrics & Gynecology) Physician
Primary
43795
WI
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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