Individual
PATRICK SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
62973
MN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
73472
WI
Other
Enumeration date
04/16/2014
Last updated
09/01/2020
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