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Individual

HANNAH P HUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1284 N SUMMIT AVE, OCONOMOWOC, WI 53066-4459
(262) 569-3080
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3130-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100030394
WI
05
1811336530
WI
Enumeration date
06/15/2013
Last updated
10/16/2023
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