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Individual

SUSAN M IWANSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
1855 S KOELLER ST, OSHKOSH, WI 54902-6214
(920) 223-7330
Mailing address
1855 S KOELLER ST, OSHKOSH, WI 54902-6214
(920) 223-7330

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
324156
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12937
DEAN
WI
01
390807236FE
UNITY
WI
05
41137800
WI
01
640003874
RAILROAD
WI
Enumeration date
11/07/2005
Last updated
05/03/2021
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