Individual
DIANE M STOREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 N NEBRASKA ST, HORICON, WI 53032-1346
(920) 485-0332
Mailing address
112 N NEBRASKA ST, HORICON, WI 53032-1346
(920) 485-0332
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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