Individual
ANGELINA ROSE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 5TH ST, BARABOO, WI 53913-2313
(608) 434-8377
Mailing address
1020 5TH ST, BARABOO, WI 53913-2313
(608) 434-8377
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313581-031
WI
Other
Enumeration date
07/11/2011
Last updated
07/11/2011
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