Kettle Moraine Ymca, Inc. Young Men's Christian Association

NPI #1073062949 in West Bend, Wisconsin

Provider Information

NPI Number: 1073062949
Entity Type: Organization
Organization Name: Kettle Moraine Ymca, Inc. Young Men's Christian Association
Primary Specialty: Health Educator
Enumeration Date: Oct 3, 2016
Last Updated: Oct 3, 2016

Practice Location

Address: 1111 W WASHINGTON ST
City: West Bend
State: Wisconsin
ZIP Code: 53095-2433
Phone: (262) 334-3405

Authorized Official

Name: MR. ROB JOHNSON
Title: EXECUTIVE DIRECTOR
Phone: (262) 247-1006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Health Educator	174H00000X	Primary

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