Individual
MILA MAE WAUKECHON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
926 S WASHINGTON ST, SHAWANO, WI 54166-3266
(715) 526-2555
Mailing address
926 S WASHINGTON ST, SHAWANO, WI 54166-3266
(715) 526-2555
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7701-031
WI
Other
Enumeration date
04/25/2006
Last updated
07/08/2007
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