Individual
MRS. MARY ANN TEETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
E8532 COUNTY ROAD O, CLINTONVILLE, WI 54929-9779
(715) 823-2825
Mailing address
E8532 COUNTY ROAD O, CLINTONVILLE, WI 54929-9779
(715) 823-2825
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
17937-031
WI
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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