Individual
MS. DEWITA LATRICE CHAMBERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1434 LINCOLN ST, RACINE, WI 53402-5031
(262) 822-6474
Mailing address
1434 LINCOLN ST, RACINE, WI 53402-5031
(262) 822-6474
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
308069-31
WI
Other
Enumeration date
09/17/2009
Last updated
09/17/2009
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