Individual
DR. MARISSA LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 E MORRISSY DR, ELKHORN, WI 53121-4395
(262) 723-3100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
125-058062
IL
207Y00000X
Otolaryngology Physician
Primary
63961
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100047991
—
WI
Enumeration date
06/17/2010
Last updated
09/09/2024
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