Individual
MRS. JODI WRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 BOOTH ST #202, FOX LAKE, WI 53933
(920) 319-2884
Mailing address
202 BOOTH ST #203, FOX LAKE, WI 53933
(920) 763-2643
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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