Individual
RUTHANN M PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 303-8700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2305
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43020611
—
WI
Enumeration date
07/07/2008
Last updated
10/13/2023
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