Individual
TAMMY STANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.D.A.
Contact information
Practice address
5192 GREENFIELD PARK RD, FITCHBURG, WI 53711-5625
(608) 772-0190
Mailing address
5192 GREENFIELD PARK RD, FITCHBURG, WI 53711-5625
(608) 772-0190
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KBRN-9KZKWR
WI
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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