Individual
LAURA JANE MAMEROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
W2312 W SCHURE DR, OCONOMOWOC, WI 53066-9322
(920) 470-7374
Mailing address
901 S WHITNEY WAY, MADISON, WI 53711-2553
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1064986
WI
Other
Enumeration date
01/15/2018
Last updated
04/30/2021
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