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Individual

CHESTON E PRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737
Mailing address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40913
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32554900
WI
Enumeration date
07/17/2006
Last updated
02/27/2017
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