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Individual

JODI L BREHM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10400 75TH ST, KENOSHA, WI 53142
(262) 648-5600
(262) 948-5735
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 648-5600
(262) 948-5735

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036112238
IL
208600000X
Surgery Physician
Primary
52096
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036112238
IL
05
35354900
WI
Enumeration date
06/22/2006
Last updated
11/24/2021
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