Individual
JASON T COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
76700
WI
Other
Enumeration date
03/21/2017
Last updated
09/14/2022
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