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Individual

MATTHEW CHARLES WORGULL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
9711 W GREENWOOD TER, MILWAUKEE, WI 53224-3919
(414) 241-6295
Mailing address
9711 W GREENWOOD TER, MILWAUKEE, WI 53224-3919
(414) 241-6295

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
137307-030
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38213700
WI
Enumeration date
06/13/2014
Last updated
06/13/2014
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