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Individual

DEB SWIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CST/CSFA

Contact information

Practice address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700
Mailing address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
142058

Other

Enumeration date
06/12/2013
Last updated
06/12/2013
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