Individual
JAIME M TROEDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2195 N SUMMIT VILLAGE WAY, OCONOMOWOC, WI 53066
(262) 567-4662
Mailing address
865 LOIS CT, HARTFORD, WI 53027-2506
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
758-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
758-019
—
WI
Enumeration date
10/16/2009
Last updated
10/16/2009
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