Individual
ALLEXA LICON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 W BELTLINE HWY STE 200, MADISON, WI 53713-2319
(082) 872-4346
(608) 287-2182
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
77126-20
WI
Other
Enumeration date
03/24/2016
Last updated
09/05/2024
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