Individual
MR. JEFF FERNHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HIS
Contact information
Practice address
2527 75TH ST, KENOSHA, WI 53143-1407
(262) 654-4703
Mailing address
2527 75TH ST, KENOSHA, WI 53143-1407
(262) 654-4703
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1022
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42831200
—
WI
Enumeration date
12/01/2009
Last updated
12/01/2009
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