MEA-AEA KENOSHA SC

KENOSHA, WI
NPI1477546737
Entity TypeOrganization
Authorized ContactSTEPHEN HOLTZCLAW
President
440-887-4718
Organization Subpart ?No
Primary Taxonomy207P00000X Emergency Medicine
Additional Taxonomies207Q00000X Family Medicine
Enumeration Date2005-08-23
Last Update Date2012-02-21
Business Address
MEA-AEA KENOSHA SC
10400 75TH ST
KENOSHA, WI 53142-7884
Phone number: 262-948-5640
Mailing Address
MEA-AEA KENOSHA SC
PO BOX 637562 MEA-AEA KENOSH SC
CINCINNATI, OH 45263-0001
Phone number: 440-887-4718