Individual
MRS. MARIA JACOBA VLACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6084 N EAGLE CREST DR, APPLETON, WI 54913-8498
(920) 428-0627
Mailing address
6084 N. EAGLE CREST DR, APPLETON, WI 54913-8498
(920) 428-0627
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
132933-30
WI
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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