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Search › Wisconsin › 225200000X

Samuel Moke

NPI 1629841721 · on the registry since 2023 · sole proprietor

Practice

Address
250 S 9th St
De Pere, WI 54115
Phone
(715) 582-2247
Fax
(920) 983-5174
Organisation at this address
Rennes Assisted Living Corp
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-11-01

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