Individual
THOMAS GRULKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10150 W NATIONAL AVE, SUITE 190, WEST ALLIS, WI 53227-2145
(414) 271-5119
Mailing address
10150 W NATIONAL AVE, SUITE 190, WEST ALLIS, WI 53227-2145
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
85-018
WI
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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