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Individual

RITA ANN FORTNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH, RN

Contact information

Practice address
50426 JOHNSTOWN RD, SOLDIERS GROVE, WI 54655-7549
(608) 735-4080
Mailing address
50426 JOHNSTOWN RD, SOLDIERS GROVE, WI 54655-7549
(608) 735-4080

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4521-016
WI
163W00000X
Registered Nurse
139651-030
WI

Other

Enumeration date
10/15/2008
Last updated
03/30/2009
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