Most Relevant Information
Provider Data
| NPI Number: | 1003403791 |
| Provider Name: | JUSTIN MICHAEL COLE CAA |
| Entity Type: | Individual |
| Taxonomy Code: | 367H00000X |
| Specialty: | Anesthesiologist Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/29/2020 |
| Last Updated: | 12/08/2021 |
Provider Practice Location
2901 W KINNICKINNIC RIVER PKWY STE 305
MILWAUKEE
WI
532153660
Practice Location Phone/Fax
| Phone: | 4146496000 |
| Fax: |
Provider Mailing Location
2901 W KINNICKINNIC RIVER PKWY STE 305
MILWAUKEE
WI
532153660
Provider Mailing Phone/Fax
| Phone: | 4146496000 |
| Fax: |