Individual
ALICE M ENYONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
38 CRAIG AVE, MADISON, WI 53705
(617) 230-4437
Mailing address
38 CRAIG AVE, MADISON, WI 53705
(617) 230-4437
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311219-031
WI
Other
Enumeration date
07/30/2009
Last updated
07/30/2009
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