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Organization

ALLERGY & ASTHMA CLINIC OF KENOSHA SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KULWANT SINGH DHALIWAL MD (PRESIDENT)
(262) 657-9390
Entity
Organization

Contact information

Practice address
4906 39TH AVE, KENOSHA, WI 53144-2108
(262) 657-9390
(262) 657-4666
Mailing address
4906 39TH AVE, KENOSHA, WI 53144-2108
(262) 657-9390
(262) 657-4666

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32656900
WI
Enumeration date
07/07/2006
Last updated
11/07/2008
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