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Mr. William T Whalen IV, CO
Prosthetic/Orthotic Supplier in Kenosha, Wisconsin
NPI 1689091316

William T Whalen IV is a Prosthetic/Orthotic Supplier based in Kenosha, WI. William T Whalen IV practices in Kenosha, WI and has the professional credentials of CO. The NPI Number for William T Whalen IV is 1689091316 and holds a License No. 213000315 (Wisconsin).

The current practice location address for William T Whalen IV is 5027 Green Bay Rd, Kenosha, WI and can be reached out via phone at 262-654-4300 and via fax at 262-654-4305.

Location: 5027 Green Bay Rd, Kenosha, WI, 53144-1771
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689091316
Provider Name
William T Whalen IV
Credential
CO
Provider Entity Type
Individual
Gender
Male
Address
5027 Green Bay Rd, Kenosha, WI, 53144-1771
Phone Number
262-654-4300
Fax Number
262-654-4305
Provider Enumeration Date
03/19/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5027 Green Bay Rd
City
Kenosha
State
Wisconsin
Zip
53144-1771
Phone Number
262-654-4300
Fax Number
262-654-4305
person
Provider Business Mailing Address Details
Address
5027 Green Bay Rd
City
Kenosha
State
Wisconsin
Zip
53144-1771
Phone Number
262-654-4300
Fax Number
262-654-4305
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
213000315 (Illinois)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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