MARK WEITKUM

ELKHORN, WI
NPI1063647147
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  13705-130)
Enumeration Date2009-05-19
Last Update Date2009-05-19
Business Address
-- MARK WEITKUM SAC-IT
797 E GENEVA ST
ELKHORN, WI 53121-2303
Phone number: 262-723-1455
Mailing Address
-- MARK WEITKUM SAC-IT
285 N JANACEK RD
BROOKFIELD, WI 53045-6102
Phone number: 262-641-9050
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