Individual
KYRA MACKENZIE ENGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 MARTIN AVE W, TURTLE LAKE, WI 54889-9069
(715) 986-4101
Mailing address
141 TONNAR ST S, RIDGELAND, WI 54763-9653
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7140-23
WI
Other
Enumeration date
04/13/2022
Last updated
08/01/2023
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