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General NPI Number Information
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NPI Number | 1508940255
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE GENETIC SERVICES, SC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 12/31/2009
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Provider Practice Location Address
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Address Line | 3720 N 124TH ST SUITE I
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City | MILWAUKEE
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State | WI
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Zip | 53222-2100
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Country | US
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Telephone | 414-393-1000
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Fax | 414-393-1399
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Provider Business Mailing Address
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Address Line | 3720 N 124TH ST SUITE I
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City | MILWAUKEE
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State | WI
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Zip | 53222-2100
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Country | US
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Telephone | 414-393-1000
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Fax | 414-393-1399
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHRISTINE R BRYKE
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Credential | MD
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Telephone | 414-393-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SC0300X
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Taxonomy Name | Clinical Cytogenetics Physician
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License Number | 33237
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | 33237
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License Number State | WI
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