Organization
TINA RIOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA M RIOS (LPN)
(608) 643-4643
Entity
Organization
Contact information
Practice address
601 21ST ST, PRAIRIE DU SAC, WI 53578-1068
(608) 643-4643
Mailing address
601 21ST ST, PRAIRIE DU SAC, WI 53578-1068
(608) 643-4643
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
305581031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38336500
—
WI
Enumeration date
07/01/2008
Last updated
07/01/2008
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