JERRY LEE HALVERSON

OCONOMOWOC, WI
NPI1952360422
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WI  43851)
Additional Taxonomies2084P0015X Psychiatry & Neurology, Psychosomatic Medicine
(Licence: WI  43851)
2084A0401X Psychiatry & Neurology, Addiction Medicine
(Licence: WI  43851)
Enumeration Date2006-03-22
Last Update Date2021-05-04
Business Address
JERRY LEE HALVERSON MD
34700 VALLEY RD
OCONOMOWOC, WI 53066-4500
Phone number: 262-646-4411
Mailing Address
JERRY LEE HALVERSON MD
34700 VALLEY RD
OCONOMOWOC, WI 53066-4500
Phone number: 262-646-4411