Teresa J Jordan PAC

NPI 1912015272 - Physician Assistant - 363A00000X

NPI Details
NPI 1912015272
Gender Female
Enumeration Date 08/28/2006
Last Updated 05/10/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
191 THEATRE RD
ONALASKA WI, 54650-8679, US
Phone (608) 392-5001
Fax
Business Location
191 THEATRE RD
ONALASKA WI, 54650-8679, US
Phone (608) 392-5001
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Wisconsin
License Number 1705
Remove 1912015272 NPI Number
 

According to our database, Teresa J Jordan PAC NPI is 1912015272, taxonomy code is 363A00000X and license number is 1705, license state is located at Wisconsin. Teresa J Jordan PAC physically located at 191 Theatre Rd, Onalaska WI, 54650-8679. NPI Number Teresa J Jordan PAC has the Individual type.

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1912015272 NPI number is provided on an as is basis without warranty of any kind. 1912015272 is maintained by the National Plan & Provider Enumeration System. The contents of Teresa J Jordan PAC are for informational purposes only.