Individual
JENNIFER ROSE DALUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 N GAMMON RD, F, MIDDLETON, WI 53562-3810
(608) 446-4071
Mailing address
1312 N GAMMON RD, F, MIDDLETON, WI 53562-3810
(608) 446-4071
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313561-31
WI
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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