Individual
SUSAN O MESSERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
143 S GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-2121
Mailing address
143 SOUTH GIBSON STREET, MEDFORD, WI 54451-1622
(715) 748-2121
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
33749
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30056100
—
WI
Enumeration date
08/11/2006
Last updated
05/16/2012
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