Individual
LAURA LYNNE BOEHLKE-BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1180 CHANDLER DR, SPOONER, WI 54801-2204
(715) 635-2151
Mailing address
1180 CHANDLER DR, SPOONER, WI 54801-2204
(715) 635-2151
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36374-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32104500
—
WI
Enumeration date
06/12/2006
Last updated
11/08/2016
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