Individual
NICHOLAS MASYGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 ALFORD PARK DR, BOX 1700, KENOSHA, WI 53140-1929
(507) 450-0898
Mailing address
2001 ALFORD PARK DR # 1700, KENOSHA, WI 53140-1929
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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