Individual
SUSAN KAY GORTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
248 BONNIE RD, COTTAGE GROVE, WI 53527-9340
(608) 839-4962
Mailing address
248 BONNIE RD, COTTAGE GROVE, WI 53527-9340
(608) 839-4962
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
25309-031
WI
Other
Enumeration date
05/03/2009
Last updated
05/03/2009
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