Organization
INCONTROL MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERSCHEL PEDDICORD (PRESIDENT/CEO)
(262) 373-0422
Entity
Organization
Contact information
Practice address
3225 GATEWAY RD, SUITE 250, BROOKFIELD, WI 53045-5134
(262) 373-0422
Mailing address
3225 GATEWAY RD, SUITE 250, BROOKFIELD, WI 53045-5134
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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