Individual
JANE E WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
325 BUTTS AVE, TOMAH, WI 54660-1412
(608) 372-5951
Mailing address
325 BUTTS AVE, TOMAH, WI 54660-1412
(608) 372-5951
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
783
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42951100
—
WI
Enumeration date
06/14/2005
Last updated
05/22/2013
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