Organization
AURORA HEALTH CARE WIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEN M. AGNELLO RD CD (MANAGER, WIC PROGRAM)
(414) 219-3344
Entity
Organization
Contact information
Practice address
1218 W KILBOURN AVE, SUITE 207, MILWAUKEE, WI 53233-1330
(414) 219-3210
Mailing address
1218 W KILBOURN AVE, SUITE 207, MILWAUKEE, WI 53233-1330
(414) 219-3210
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
251K00000X
TAXONOMY
WI
Enumeration date
10/09/2009
Last updated
10/09/2009
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