Individual
MS. EDITH JOYCE MOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
803 AUGUSTA AVE, WAUSAU, WI 54403-3336
(715) 581-3342
Mailing address
803 AUGUSTA AVE, WAUSAU, WI 54403-3336
(715) 581-3342
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
315716-31
WI
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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