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Robert H House
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NPI Number Detailed Information
Provider Information:
| Name: | Robert H House |
| Gender: | M |
| Provider License Number If Given: | 17291 |
NPI Information:
| NPI: | 1356336879 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
| Address: | 635 W OSHKOSH ST Ripon, WI 54971 |
| Phone Number: | 9207456900 |
| Fax Number: |
Provider Business Practice Location Address:
| Address: | 635 W OSHKOSH ST Ripon, WI 54971 |
| Phone Number: | 9207456900 |
| Fax Number: |
Provider Taxonomy:
| Primary: | 207Q00000X |
| Secondary (if any): | |
| State: | WI |
