Individual
TAYLOR C KLUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8084-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100296903
—
WI
Enumeration date
08/22/2024
Last updated
01/07/2025
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