Individual
MICHAEL MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
(715) 743-5410
Mailing address
N11750 OWEN AVE, OWEN, WI 54460-7917
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/21/2009
Last updated
04/21/2009
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