Brody David Ilstrup
Brody David Ilstrup is a Student in an Organized Health Care Education/Training Program in Kenosha, Wisconsin. Registered with an NPI since 2019.
- In the registry since
- 2019
Practice location Address checks out
2001 Alford Park DrKenosha, WI 53140-1927
Phone: (612) 865-8656
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1578129102 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 20, 2019 |
| Last updated in NPPES | May 20, 2019 |
| Mailing address | 2001 Alford Park Dr, Kenosha, WI 53140-1927 |
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