Individual
MRS. MARY JO J IGL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
536 E NORTH ST, JEFFERSON, WI 53549-1531
(920) 674-6658
Mailing address
536 E NORTH ST, JEFFERSON, WI 53549-1531
(920) 674-6658
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27195-031
WI
Other
Enumeration date
02/16/2009
Last updated
02/16/2009
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