Organization
KORNELY PODIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA G. KORNELY DPM (OWNER)
(262) 335-2930
Entity
Organization
Contact information
Practice address
2358 W WASHINGTON ST, WEST BEND, WI 53095-2118
(262) 335-2930
(262) 335-2931
Mailing address
2358 W WASHINGTON ST, WEST BEND, WI 53095-2118
(262) 335-2930
(262) 335-2931
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
774-025
WI
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43225400
—
WI
Enumeration date
05/27/2006
Last updated
02/01/2022
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