Individual
MR. JOHN P GORENC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147
(262) 249-4620
(262) 249-7132
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 647-6326
(414) 671-8860
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
801-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40996400
—
WI
Enumeration date
08/20/2006
Last updated
07/09/2007
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