Individual
MRS. MARCIA JANE FERNHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
730 WASHINGTON AVE, RACINE, WI 53403-1146
(262) 636-9203
(262) 636-9165
Mailing address
730 WASHINGTON AVE, RACINE, WI 53403-1146
(262) 636-9203
(262) 636-9165
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41862300
—
WI
Enumeration date
04/24/2008
Last updated
04/24/2008
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