Individual
BLAINE AMSTADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1645 PEDERSON ST, MONICO, WI 54501-7716
(715) 490-0570
Mailing address
1645 PEDERSON ST, MONICO, WI 54501-7716
(715) 490-0570
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
169353
WI
Other
Enumeration date
06/09/2010
Last updated
06/09/2010
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