Individual
KIMBERLY MARIE KUPHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
425 PINE RIDGE BLVD STE 209, WAUSAU, WI 54401-4123
(715) 847-0400
Mailing address
425 PINE RIDGE BLVD STE 209, WAUSAU, WI 54401-4123
(715) 847-0400
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1142574
WI
Other
Enumeration date
05/31/2017
Last updated
03/17/2018
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