Individual
MARCIA JOAN KOOIMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
N3187 ELM RIDGE RD, DELAVAN, WI 53115-3104
(262) 325-5645
Mailing address
N3187 ELM RIDGE RD, DELAVAN, WI 53115-3104
(262) 325-5645
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
23536-031
WI
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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