Most Relevant Information
Provider Data
| NPI Number: | 1003408592 |
| Provider Name: | MEGAN ELIZABETH MAHLKUCH |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/06/2021 |
| Last Updated: | 02/06/2021 |
Provider Practice Location
2001 ALFORD PARK DR
KENOSHA
WI
531401927
Practice Location Phone/Fax
| Phone: | 6086366324 |
| Fax: |
Provider Mailing Location
634 VINEY RD
BELLEVILLE
WI
535089531
Provider Mailing Phone/Fax
| Phone: | 6086366324 |
| Fax: |