Individual
JEANNE STARK CASADONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7600 75TH ST STE 122, KENOSHA, WI 53142-7697
(262) 771-9051
Mailing address
6053 109TH AVE, KENOSHA, WI 53142-7598
(262) 857-7189
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
925
WI
Other
Enumeration date
07/03/2019
Last updated
12/08/2021
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