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Individual

MS. JANE MARIE FRAZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
814 JACKSON ST, STOUGHTON, WI 53589-1520
(608) 873-6448
Mailing address
585 CTY HWY PB, BELLEVILLE, WI 53508
(608) 424-6221

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1674-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40133200
WI
Enumeration date
05/17/2007
Last updated
07/09/2007
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