Individual
MRS. MARY S MANZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
N 793 ELM STREET, DALTON, WI 53926-0002
(920) 394-3791
Mailing address
N793 ELM STREET, PO BOX 2, DALTON, WI 53926-0002
(920) 394-3791
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
49793-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39939700
—
WI
Enumeration date
03/16/2006
Last updated
07/08/2007
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