Individual
MR. KRIS RUDY VANDERKOOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 S SUNNY SLOPE RD, SUNNYSLOPE PRIMARY CARE CLINIC, BROOKFIELD, WI 53005-7060
(414) 805-9600
(414) 805-9645
Mailing address
1350 S SUNNY SLOPE RD, SUNNYSLOPE PRIMARY CARE CLINIC, BROOKFIELD, WI 53005-7060
(414) 805-9600
(414) 805-9645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
53968
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467625178
—
WI
Enumeration date
04/02/2008
Last updated
06/23/2011
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