Individual
AMIE JABANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
534 AZTALAN DR, MADISON, WI 53718-3205
(608) 445-2399
Mailing address
534 AZTALAN DR, MADISON, WI 53718-3205
(608) 445-2399
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
24362030
WI
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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