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Individual

MRS. SANDRA K WACHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
834 TEUTONIA DR, BURLINGTON, WI 53105-1034
(262) 767-0219
Mailing address
834 TEUTONIA DR, BURLINGTON, WI 53105-1034
(262) 767-0219

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
22203-031
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38297600
WI
Enumeration date
04/05/2006
Last updated
07/09/2007
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