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Individual

LEA G CORNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
505 CENTER ST, WONEWOC, WI 53968-9002
(608) 464-3111
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21423
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30393300
WI
Enumeration date
06/02/2006
Last updated
06/19/2008
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