Individual
MS. MARY LAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8901 N. 76TH STREET, MILWAUKEE, WI 53223
(414) 354-0772
(414) 365-0773
Mailing address
8901 N. 76TH STREET, MILWAUKEE, WI 53223
(414) 354-0772
(414) 365-0773
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
229-023
WI
Other
Enumeration date
09/14/2006
Last updated
07/15/2010
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