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Individual

MICHAEL ALTO WISLOCKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1319
(502) 636-7449
(502) 636-7950
Mailing address
DEPT 86236, PO BOX 950195, LOUISVILLE, KY 40295-0195
(502) 473-2100
(502) 459-6461

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3231A
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74001892
KY
Enumeration date
12/23/2005
Last updated
10/11/2007
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