Individual
DOROTHEA M ANICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
417 MAIN ST, MUKWONAGO, WI 53149
(262) 363-8097
Mailing address
417 MAIN ST, MUKWONAGO, WI 53149
(262) 363-8097
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2205-026
WI
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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