Kallembach, Brent

Kallembach, Brent is an individual health care provider with primary practice located at 1000 N Oak Ave , Marshfield WI 54449. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kallembach, Brent can be contacted via phone (715) 387-5245.

Contact Information

Primary practice address
1000 N Oak Ave Marshfield WI 54449
Phone: (715) 387-5245
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1248 Wisconsin

Profile Details

NPI number 1396847232
LBN Legal business name Kallembach, Brent
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396847232 NPPES
Wisconsin MEDICAID 42999800

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