Individual
CLARAN STOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8216 ANNA AVE, WATERFORD, WI 53185-1383
(262) 895-2812
Mailing address
8216 ANNA AVE, WATERFORD, WI 53185-1383
(262) 895-2812
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303214-31
WI
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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