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Individual

BRANDY L STORK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
H.I.S.

Contact information

Practice address
5027 GREEN BAY RD, SUITE 104, KENOSHA, WI 53144-1771
(262) 657-5350
(262) 764-0598
Mailing address
5200 WASHINGTON AVE, SUITE 102, RACINE, WI 53406-4238
(262) 637-5668
(262) 637-5009

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1473
WI

Other

Enumeration date
10/27/2015
Last updated
10/27/2015
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