Individual
NATHANIEL J AGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1853 N CASALOMA DR, APPLETON, WI 54913-7980
(920) 328-2001
Mailing address
1853 N CASALOMA DR, APPLETON, WI 54913-7980
(920) 328-2001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
147069
WI
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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