Provider Demographics
NPI:1821733056
Name:MUKORA, CHRISTOPHER K
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:K
Last Name:MUKORA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 WHITE PINE WAY
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53719-5143
Mailing Address - Country:US
Mailing Address - Phone:608-422-9023
Mailing Address - Fax:
Practice Address - Street 1:6107 WHITE PINE WAY
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719-5143
Practice Address - Country:US
Practice Address - Phone:608-422-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)