Individual
MARCIE CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 S WERNER ST, ADAMS, WI 53910-9348
(608) 548-4958
Mailing address
200 S WERNER ST, ADAMS, WI 53910-9348
(608) 548-4958
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
176617-30
WI
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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