Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 1001219-15 | WI |
Y | 213EG0000X | General Practice | 1001219-15 | WI |
NPI | 1003287228 |
---|---|
Provider Name | Robin Rott |
First Address | Holmen, WI 54636-9467 |
Second Address | Holmen, WI 54636-9467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2015 |
Last Update Date | 14/10/2015 |