Individual
ZORAN JOVICIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3239 S 58TH ST UNIT 104, MILWAUKEE, WI 53219-4365
(414) 335-5479
Mailing address
3239 S 58TH ST UNIT 104, MILWAUKEE, WI 53219-4365
(414) 335-5479
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0016003
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016003
DQA
WI
Enumeration date
10/08/2020
Last updated
10/08/2020
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