Individual
KARA VANDE WALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 THEDA CLARK MEDICAL PLZ STE 400, NEENAH, WI 54956-2763
(920) 725-4527
Mailing address
100 THEDA CLARK MEDICAL PLZ STE 400, NEENAH, WI 54956-2763
(659) 954-5000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5920
WI
208600000X
Surgery Physician
Primary
67229-20
WI
208600000X
Surgery Physician
ME156348
FL
Other
Enumeration date
04/09/2015
Last updated
08/15/2023
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