DARREN R. ELLENBOLT

MUKWONAGO, WI
NPI1700855012
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: WI  47860)
Enumeration Date2006-03-17
Last Update Date2011-11-02
Business Address
-- DARREN R. ELLENBOLT M.D.
240 MAPLE AVE. PROHEALTH CARE MEDICAL ASSOCIATES, INC.
MUKWONAGO, WI 53149-8475
Phone number: 262-928-1900
Mailing Address
-- DARREN R. ELLENBOLT M.D.
N17 W24100 RIVERWOOD DR. PROHEALTH CARE MEDICAL ASSOCIATES, INC.
WAUKESHA, WI 53188-1177
Phone number: 262-928-4100
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