Individual
TINA MARIE ALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
E4539 COUNTY ROAD B, SPRING GREEN, WI 53588-9651
(608) 553-2077
Mailing address
E4539 COUNTY ROAD B, SPRING GREEN, WI 53588-9651
(608) 553-2077
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304259-31
WI
Other
Enumeration date
05/18/2014
Last updated
05/20/2014
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