Individual
BRIAN P MCCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
678 INVERNESS ST, OREGON, WI 53575-3848
(608) 263-0333
Mailing address
678 INVERNESS ST, OREGON, WI 53575-3848
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4456-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669958070
—
WI
Enumeration date
07/18/2018
Last updated
11/07/2024
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