Individual
SHANNON FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
415 JOHNSON ST, LA CROSSE, WI 54601-5337
(608) 498-1108
Mailing address
415 JOHNSON ST, LA CROSSE, WI 54601-5337
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318924
WI
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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