Individual
KENNETH BYOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2514 S 102ND ST, STE 160, WEST ALLIS, WI 53227-2142
(414) 255-0300
(414) 543-9601
Mailing address
139 N 85TH ST, WAUWATOSA, WI 53226-4601
(414) 469-1501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44309
WI
Other
Enumeration date
11/01/2006
Last updated
04/21/2016
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