Healthcare Provider Details

I. General information

NPI: 1952195026
Provider Name (Legal Business Name): ROBERT ZIOBRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 04/05/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34700 VALLEY RD
OCONOMOWOC WI
53066-4500
US

IV. Provider business mailing address

2718 NORTHVIEW RD UNIT 19
WAUKESHA WI
53188-2034
US

V. Phone/Fax

Practice location:
  • Phone: 833-308-5887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: