Individual
BETH MACKINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 ELLIS ST, KEWAUNEE, WI 54216-1005
(920) 559-9463
Mailing address
215 ELLIS ST, KEWAUNEE, WI 54216-1005
(920) 559-9463
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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