Individual
CAROLYN QUELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
W180N7950 TOWN HALL RD, MENOMONEE FALLS, WI 53051-4049
(262) 255-2500
Mailing address
W180N7950 TOWN HALL RD, MENOMONEE FALLS, WI 53051-4049
(262) 255-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
818
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42943300
—
WI
Enumeration date
04/24/2006
Last updated
09/16/2010
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