Individual
KEATON LAWSON WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4282 E ROCKTON RD, ROSCOE, IL 61073-7420
(779) 696-9000
Mailing address
2000 UNIVERSITY AVE, DUBUQUE, IA 52001-5050
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/26/2022
Last updated
06/10/2024
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