Individual
MRS. GERALYN CAROL DORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1217 LILLIAN ST, FORT ATKINSON, WI 53538-1530
(262) 613-2595
Mailing address
1217 LILLIAN ST, FORT ATKINSON, WI 53538-1530
(262) 613-2595
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
D650-2836-1611-00
WI
Other
Enumeration date
07/27/2024
Last updated
07/27/2024
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