Individual
ISAAC KALLIES PABST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2839 WYLDEWOOD RD, OSHKOSH, WI 54904-9225
(920) 226-1900
Mailing address
2839 WYLDEWOOD RD, OSHKOSH, WI 54904
(920) 226-1900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16339130
WI
Other
Enumeration date
08/01/2011
Last updated
08/01/2011
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