Individual
KOU XIONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1323 S 13TH AVE, WAUSAU, WI 54401-5816
(715) 870-1166
Mailing address
1323 S 13TH AVE, WAUSAU, WI 54401-5816
(715) 870-1166
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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