Individual
DR. CHARLES EDWARD ALLEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1185 CORPORATE CENTER DR, STE 175, OCONOMOWOC, WI 53066-4887
(262) 928-8400
Mailing address
1185 CORPORATE CENTER DR, STE 175, OCONOMOWOC, WI 53066-4887
(262) 928-8400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
61157-020
WI
Other
Enumeration date
06/29/2010
Last updated
03/04/2016
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