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Individual

MRS. SALLY RAE NIZIOL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
HIGHWAY 64, W6604, MEDFORD, WI 54451
(171) 574-8091
Mailing address
721 FLORENCE ST, IRONWOOD, MI 49938-1417
(190) 693-2500

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38297500
WI
Enumeration date
04/27/2006
Last updated
07/09/2007
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