Individual
ATHENA KORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3631 W BROWN ST, MILWAUKEE, WI 53208-1936
(305) 988-5199
Mailing address
3631 W BROWN STREET, MILWAUKEE, WI 53208
(305) 988-5199
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
812814045
WI
Other
Enumeration date
06/17/2016
Last updated
11/07/2016
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