Individual
JOHN KOHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
191 THEATER RD, ONALASKA, WI 54650-8679
(608) 785-0940
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(171) 583-8522
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
60799
MN
207N00000X
Dermatology Physician
73195
WI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
73195
WI
Other
Enumeration date
06/05/2015
Last updated
10/05/2020
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