Individual
MELISSA ELEANOR DITZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2115 SCHUSTER DR, BELOIT, WI 53511-3145
(608) 371-7351
Mailing address
2115 SCHUSTER DR, BELOIT, WI 53511-3145
(608) 371-7351
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312517-31
WI
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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