Individual
LAURA B COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
405 ANDERSON ST., DEFOREST, WI 53532
(920) 366-2400
Mailing address
405 ANDERSON ST., DEFOREST, WI 53532
(920) 366-2400
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307451-31
WI
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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