Individual
KYLE RAYMOND BLINDAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
(262) 303-5057
Mailing address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
(262) 303-5057
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8140-23
WI
Other
Enumeration date
02/26/2019
Last updated
10/11/2024
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