Individual
BRANDON FETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
160 PROUDFIT ST, MADISON, WI 53715-1428
(608) 556-8155
Mailing address
160 PROUDFIT ST., MADISON, WI 53715
(608) 556-8155
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307420-31
WI
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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