Individual
PATTI ANN BALESTRIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-0510
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-0510
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
945023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42964500
—
WI
Enumeration date
07/31/2006
Last updated
07/08/2007
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