Individual
TERRY D HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1501 AIRPORT RD, WAUKESHA, WI 53188-2461
(262) 548-7986
(262) 970-4799
Mailing address
13650 W GRAHAM ST, NEW BERLIN, WI 53151-2572
(262) 938-9323
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
79688-30
WI
Other
Enumeration date
11/12/2017
Last updated
11/12/2017
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