Individual
MR. WAYNE DONELL BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3014 WORTHINGTON AVE, APT 2, MADISON, WI 53714-1609
(608) 249-8440
Mailing address
3014 WORTHINGTON AVE, APT 2, MADISON, WI 53714-1609
(608) 249-8440
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303901
SC
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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