Individual
KAYLA M KOEPPL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-3700
(920) 720-3806
Mailing address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
(920) 720-3719
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
15644
WI
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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