Individual
SUZANNE DEROSIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3910 W BRIDGE, GREENFIELD, WI 53221
(561) 371-3101
Mailing address
3910 W BRIDGE ST, GREENFIELD, WI 53221-4538
(561) 371-3101
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33690-31
WI
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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