Provider Demographics
NPI:1952648222
Name:KH SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:KH SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSCLAW
Authorized Official - Suffix:
Authorized Official - Credentials:CST, CSFA
Authorized Official - Phone:262-565-7683
Mailing Address - Street 1:N115W20014 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-2926
Mailing Address - Country:US
Mailing Address - Phone:262-565-7383
Mailing Address - Fax:847-720-4796
Practice Address - Street 1:N115W20014 N WOODLAND DR.
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-2926
Practice Address - Country:US
Practice Address - Phone:262-565-7683
Practice Address - Fax:847-720-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36684246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty