Individual
GENA MARIE DERMODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-2135
Mailing address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-2135
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
61665
WI
Other
Enumeration date
03/21/2012
Last updated
12/02/2021
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