Individual
MS. JAN MARIE WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BC-HIS
Contact information
Practice address
2525 WASHINGTON ST, MANITOWOC, WI 54220
(920) 682-4990
(920) 769-5131
Mailing address
2525 WASHINGTON ST., MANITOWOC, WI 54220
(920) 682-4990
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1169
WI
237700000X
Hearing Instrument Specialist
1169-060
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42834600
—
WI
Enumeration date
05/05/2008
Last updated
03/10/2017
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