Organization
PROFESSIONAL HOME CARE PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANZHELA ANDREICHYK VENT CERTIFIED (LPN)
(262) 942-8484
Entity
Organization
Contact information
Practice address
10152 8TH AVE, PLEASANT PRAIRIE, WI 53158-5413
(262) 942-8484
Mailing address
10152 8TH AVE, PLEASANT PRAIRIE, WI 53158
(262) 942-8484
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
307458-31
WI
Other
Enumeration date
11/29/2011
Last updated
12/07/2011
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