Individual
TRAVIS EDWARD VANDEN HEUVEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
N1762 BUCHANAN RD, KAUKAUNA, WI 54130-9207
(920) 574-8066
Mailing address
N1762 BUCHANAN RD, KAUKAUNA, WI 54130-9207
(920) 574-8066
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320113 - 31
WI
Other
Enumeration date
03/13/2016
Last updated
03/13/2016
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