Individual
MELISSA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2896 S SEMINOLE HWY, 9, FITCHBURG, WI 53711-7015
(847) 899-4397
Mailing address
2896 S SEMINOLE HWY APT 9, FITCHBURG, WI 53711-7015
(847) 899-4397
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
31786431
WI
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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