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Individual

CORINE BAUMSTARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1903 ENGLISH ST, RACINE, WI 53404-2360
(262) 995-5629
Mailing address
1903 ENGLISH ST, RACINE, WI 53404-2360
(262) 995-5629

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
301697
WI

Other

Enumeration date
08/04/2014
Last updated
08/04/2014
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