Theresa Pardoe D.o.

NPI 1083635189 - Family Medicine - 207Q00000X

NPI Details
NPI 1083635189
Enumeration Date 07/22/2006
Last Updated 07/22/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name THERESA MARIE THERESA
Position OWNER
Phone (414) 545-1120
Fax (414) 545-2505
Practice Location
9305 W NATIONAL AVE
WEST ALLIS WI, 53227-1541, US
Phone (414) 545-1120
Fax (414) 545-2505
Business Location
9305 W NATIONAL AVE
WEST ALLIS WI, 53227-1541, US
Phone (414) 545-1120
Fax (414) 545-2505
Toxanomy
Taxonomy Code 207Q00000X
License State Wisconsin
License Number 29660
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According to our database, Theresa Pardoe D.o. NPI is 1083635189, taxonomy code is 207Q00000X and license number is 29660, license state is located at Wisconsin. Theresa Pardoe D.o. physically located at 9305 W National Ave, West Allis WI, 53227-1541. NPI Number 1033115704 has the healthcare provider type.

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1083635189 NPI number is provided on an as is basis without warranty of any kind. 1083635189 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa Pardoe D.o. are for informational purposes only.