Individual
EVERETT VANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4006 E LEONARD RD, DEFOREST, WI 53532-2636
(651) 276-4120
Mailing address
4006 E LEONARD RD, DEFOREST, WI 53532-2636
(651) 276-4120
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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