Individual
PONGELLA WELCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4018 W CAPITOL DR, MILWAUKEE, WI 53216-2531
(414) 499-4882
Mailing address
4018 W CAPITOL DR, MILWAUKEE, WI 53216-2531
(414) 499-4882
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WI
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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