Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | LWI014 | UT |
NPI | 1063020782 |
---|---|
Provider Name | Patricia Carol Ziegler |
First Address | Sun Prairie, WI 53590-2875 |
Second Address | Sun Prairie, WI 53590-2875 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2020 |
Last Update Date | 20/07/2020 |