Individual
GUSTAVO URBINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4623 75TH ST, SUITE 279, KENOSHA, WI 53142-3701
(773) 495-3796
Mailing address
4623 75TH ST, SUITE 279, KENOSHA, WI 53142-3701
(773) 495-3796
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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