Individual
JAN MAILLOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
856 FAIR ST, MINERAL POINT, WI 53565-1409
(608) 987-5987
Mailing address
2649 COUNTY ROAD A, MINERAL POINT, WI 53565-9123
(608) 987-1166
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
932-23
WI
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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