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Individual

JOSHUA CHRISOPULOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3735
(262) 884-4088
Mailing address
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3735
(262) 884-4088

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5273-023
WI
363AM0700X
Medical Physician Assistant
083504
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100138716
WI
Enumeration date
08/27/2016
Last updated
11/30/2021
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