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Organization

HOLVERSON THERAPEUTICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROL M. MICHELS (OWNER)
(262) 552-8832
Entity
Organization

Contact information

Practice address
326 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-2819
(847) 281-9999
Mailing address
601 10TH PL, KENOSHA, WI 53140-1169

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
056005773
IL

Other

Enumeration date
10/30/2008
Last updated
10/30/2008
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