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Individual

CAROL L JEGLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
112 JEFFERSON ST, WEST UNION, IA 52175-1022
(563) 422-3811
(563) 422-9520
Mailing address
1836 SOUTH AVE, CREDENTIALING, LA CROSSE, WI 54601-5429
(800) 362-9567
(608) 775-4429

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1650
IA

Other

Enumeration date
02/07/2006
Last updated
06/09/2008
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