Individual
JESSICA THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4404 STATE ROAD 70, WEBSTER, WI 54893-9251
(715) 349-8554
Mailing address
11478 N SHORE DR, GRANTSBURG, WI 54840-8059
(715) 338-8210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201864
WI
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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