Individual
ANNETTE B CAPORUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1200 OAKLEAF WAY, SUITE A, ALTOONA, WI 54720-2245
(715) 832-1400
(715) 832-4187
Mailing address
1200 OAKLEAF WAY, SUITE A, ALTOONA, WI 54720-2245
(715) 832-1400
(715) 832-4187
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
849
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43232800
—
WI
01
—
P00713752
RR MEDICARE PTAN
WI
Enumeration date
09/20/2006
Last updated
01/15/2015
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