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Edwin Bacalso
NPI 1023661659 · on the registry since 2019 · sole proprietor
Practice
- Address
- 13111 N Port Washington Rd
Thiensville, WI 53097 - Phone
- (262) 243-6127
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-05-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin