Individual
AMY TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1526 ROSE ST, LA CROSSE, WI 54603-4500
(608) 781-9880
Mailing address
1544 PARK AVE, LA CROSSE, WI 54601-5753
(507) 458-4080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10834-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10834-33
—
WI
Enumeration date
03/24/2021
Last updated
12/02/2021
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