Individual
JANE CARY PALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10117 74TH ST, SUITE 150, KENOSHA, WI 53142-7533
(262) 697-7770
Mailing address
10117 74TH ST, SUITE 150, KENOSHA, WI 53142-7533
(262) 697-7770
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29575020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21255800
—
WI
Enumeration date
01/02/2007
Last updated
07/08/2007
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