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Individual

SOCHEAT EAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16 E GORHAM ST, MADISON, WI 53703-2173
(630) 542-9192
Mailing address
16 E GORHAM ST, MADISON, WI 53703-2173
(630) 542-9192

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
06/16/2023
Last updated
06/16/2023
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