Individual
RAQUEL S RISTAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
120 2ND AVE SE, WAUKON, IA 52172-2073
(563) 568-3000
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
090856
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265934384
—
IA
Enumeration date
03/05/2018
Last updated
09/22/2020
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