Organization
MEDCO MILWAUKEE LLC
Active
Other names
Medco Milwaukee LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRIY CHESTER APN (OWNER)
(262) 292-8101
Entity
Organization
Contact information
Practice address
1340 W TOWNE SQUARE RD STOP 5, MEQUON, WI 53092-5076
(262) 292-8101
Mailing address
1340 W TOWNE SQUARE RD STOP 5, MEQUON, WI 53092-5076
(262) 292-8101
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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