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Individual

MR. DAVID JONATHAN EVERSOLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN REGISTERED NURSE

Contact information

Practice address
1516 DEVALERA, PLATTEVILLE, WI 53818-2029
(608) 348-5753
Mailing address
776 UNION ST, PLATTEVILLE, WI 53818-2029
(608) 348-5753

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38312100
WI
Enumeration date
04/02/2008
Last updated
04/02/2008
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