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Individual

MARK AEPPLI VAN ETTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
707 ASH ST, SPOONER, WI 54801-1234
(715) 635-2151
(715) 635-8768
Mailing address
707 ASH ST, SPOONER, WI 54801-1234
(715) 635-2151
(715) 635-8768

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
25178-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30518900
WI
Enumeration date
07/17/2006
Last updated
05/09/2011
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