Individual
THERESA MARIE BLOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
S4875 CTY RD D, ROCK SPRINGS, WI 53961-9714
(608) 524-8011
Mailing address
S4875 CTY RD D, ROCK SPRINGS, WI 53961-9714
(608) 524-8011
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310840-031
WI
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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