Individual
BRIAN WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 WEST 7TH ST., APPLETON, WI 54911
(920) 739-3235
Mailing address
607 W 7TH ST, APPLETON, WI 54911-5923
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16523-130
WI
Other
Enumeration date
03/13/2014
Last updated
03/18/2014
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