PISANG LLC
Osteopathic Medicine at Us Highway 18, Prairie Du Chien, WI

License number
Wisconsin 52325-20
Category
Osteopathic Medicine
Type
Internal Medicine
License number
Wisconsin 54950
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: BENNY KUSUMA M.D.
Title: SOLE OWNER
Phone: (316) 209-1424
Address
Address 2
37868 Us Highway 18, Prairie Du Chien, WI 53821
PO Box 3602, La Crosse, WI 54602
National Provider ID: 1316302797
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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