Individual
DINA A EISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
N3293 QUEEN RD, LAKE GENEVA, WI 53147-3332
(262) 949-8080
Mailing address
N3293 QUEEN RD, LAKE GENEVA, WI 53147-3332
(262) 949-8080
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310667-031
WI
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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