Individual
THOMAS WILLIAM JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 MAPLE LN, ASHLAND, WI 54806-3626
(715) 685-5500
Mailing address
1615 MAPLE LN, ASHLAND, WI 54806-3689
(715) 685-5500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2182
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
9210-33
WI
Other
Enumeration date
12/12/2017
Last updated
09/10/2019
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