Individual
VANG THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADMINISTRATOR
Contact information
Practice address
1402 GREENWAY CROSS, SUITE 101, MADISON, WI 53713-3181
(608) 251-2273
(866) 748-3232
Mailing address
1402 GREENWAY CROSS, SUITE 101, MADISON, WI 53713-3181
(608) 251-2273
(866) 748-3232
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
100014484
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100014484
—
WI
Enumeration date
06/03/2014
Last updated
06/03/2014
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