Individual
MATTHEW J VARNUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2796 PLANTATION ROAD, PELICAN LAKE, WI 54463-9501
(715) 360-1585
Mailing address
2796 PLANTATION ROAD, PELICAN LAKE, WI 54463-9501
(715) 360-1585
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
315136-31
WI
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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