Individual
MRS. FLORENCE TAVERA NEILITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
410 DEWEY ST, WISCONSIN RAPIDS, WI 54494-4715
(715) 421-7474
(715) 422-7752
Mailing address
410 DEWEY ST, WISCONSIN RAPIDS, WI 54494-4715
(715) 421-7474
(715) 422-7752
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3764-23
WI
Other
Enumeration date
07/25/2016
Last updated
07/25/2016
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