Organization
DRS FULLIN MANDA KREAGER & ABBO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN J FULLIN MD FACC (PHYSICIAN)
(262) 656-8271
Entity
Organization
Contact information
Practice address
6308 8TH AVE, STE 3060, KENOSHA, WI 53143-5082
(262) 656-8271
(262) 656-8255
Mailing address
6308 8TH AVE, STE 3060, KENOSHA, WI 53143-5082
(262) 656-8271
(262) 656-8255
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
WI
Other
Enumeration date
12/01/2005
Last updated
10/24/2007
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