Individual
MAO VANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 N 27TH ST, SHEBOYGAN, WI 53081-2034
(920) 946-0187
Mailing address
1536 FLORIDA AVE, SHEBOYGAN, WI 53081-7161
(920) 912-3364
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313414-031
WI
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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