Individual
ELLEN IGL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
N8053 HWY 33, BEAVER DAM, WI 53916-9762
(920) 885-4144
Mailing address
N8053 HWY 33, BEAVER DAM, WI 53916-9762
(920) 885-4144
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
WI
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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