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Organization

GLENN CAINE DO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLENN CAINE (PRESIDENT)
(414) 313-4652
Entity
Organization

Contact information

Practice address
620 BELL ST, WAUKESHA, WI 53186-5172
(414) 313-4652
Mailing address
620 BELL ST, WAUKESHA, WI 53186-5172

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
34605
WI

Other

Enumeration date
10/19/2011
Last updated
10/13/2012
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