Individual
LISA MARIE FARGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
334 JUSTIN DR, MOUNT HOREB, WI 53572-2199
(608) 437-4220
Mailing address
301 JUSTIN DR, MOUNT HOREB, WI 53572-3306
(608) 437-6254
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
WI
Other
Enumeration date
03/14/2006
Last updated
09/06/2007
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