Carissa Ann Coorough PA

NPI 1588949333 - Physician Assistant - 363AM0700X

NPI Details
NPI 1588949333
Gender Female
Enumeration Date 10/12/2011
Last Updated 11/08/2013
Entity Type Individual
Active Over 5 years ago
Practice Location
1836 SOUTH AVE
LA CROSSE WI, 54601-5429, US
Phone (608) 782-7300
Fax
Business Location
1836 SOUTH AVE
LA CROSSE WI, 54601-5429, US
Phone (608) 782-7300
Fax
Toxanomy
Taxonomy Code 363AM0700X
License State Wisconsin
License Number 2872
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According to our database, Carissa Ann Coorough PA NPI is 1588949333, taxonomy code is 363AM0700X and license number is 2872, license state is located at Wisconsin. Carissa Ann Coorough PA physically located at 1836 South Ave, La Crosse WI, 54601-5429. NPI Number Carissa Ann Coorough PA has the Individual type.

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1588949333 NPI number is provided on an as is basis without warranty of any kind. 1588949333 is maintained by the National Plan & Provider Enumeration System. The contents of Carissa Ann Coorough PA are for informational purposes only.