Provider Information for 1700320074
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DARLENE WILKEN SAC-IT
Sex: Female
NPI: 1700320074
Last Updated: 2016-12-06
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1700320074 | ||||||||
| Enumeration Date | 2016-12-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2842 S BUSINESS DR SHEBOYGAN, WI 53081-6518 United States Phone: 920-458-2765 | Fax: | ||||||||
| Primary Practice Address | 2842 S. BUSINESS DR SHEBOYGAN, WI 53081 United States Phone: 920-458-6527 | Fax: | ||||||||
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