Individual
EDWARD THEODORE WASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 969-7905
(920) 969-7969
Mailing address
623 HAYLETT ST, NEENAH, WI 54956-4105
(920) 725-1892
(920) 725-1892
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
1930-123
WI
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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