Individual
DIANE LEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
354 N MAIN ST, OREGON, WI 53575-1426
(608) 835-9423
Mailing address
354 N MAIN ST, OREGON, WI 53575-1426
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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