Individual
LORELEI E GLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
W4051 COUNTY RD NN, ELKHORN, WI 53121
(262) 741-3200
(262) 741-3217
Mailing address
PO BOX 1005, ELKHORN, WI 53121
(262) 741-3200
(262) 741-3217
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303098-031
WI
Other
Enumeration date
06/12/2009
Last updated
06/12/2009
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