Individual
SAMUEL MBAKI MOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 S 9TH ST, DE PERE, WI 54115-3919
(715) 582-2247
(920) 983-5174
Mailing address
119 N JACKSON ST, GREEN BAY, WI 54301-4934
(214) 616-7318
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4122-19
WI
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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