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Individual

KAYLA ELAINE3 GARZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1201 S LEE ST, APPLETON, WI 54915-3723
(920) 858-3302
Mailing address
652 W 5TH AVE, OSHKOSH, WI 54902-5833
(920) 376-4458

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
319551
WI

Other

Enumeration date
08/09/2018
Last updated
08/09/2018
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