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Individual

KELLY BENEDUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
N56W26530 RICHMOND RD, SUSSEX, WI 53089-4299
(262) 538-1360
Mailing address
315 WESTROCK BLVD UNIT 102, HARTLAND, WI 53029-2923
(612) 310-0785

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
08/06/2026
Last updated
08/06/2026
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