Individual
MR. JOHN MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO1410
Contact information
Practice address
2555 W KENBOERN DR, GLENDALE, WI 53209-1835
(414) 540-1202
Mailing address
2555 W KENBOERN DR, GLENDALE, WI 53209-1835
(414) 540-1202
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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