Individual
CHANTALL WILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFM, CST, CNA
Contact information
Practice address
1607 W WAUSAU AVE, WAUSAU, WI 54401-2002
(715) 486-6343
Mailing address
1607 W WAUSAU AVE, WAUSAU, WI 54401-2002
(715) 486-6343
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
CFM03571
WI
246ZS0410X
Surgical Technologist
—
WI
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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