Individual
TIMOTHY E WASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2720 PLAZA DR, SUITE 1100, WAUSAU, WI 54401-4158
(715) 847-2472
Mailing address
2720 PLAZA DR, SUITE 1100, WAUSAU, WI 54401-4158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4881-33
WI
Other
Enumeration date
07/23/2012
Last updated
09/02/2014
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