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1023487170
MADELINE DALLMAN
MEQUON, WI
NPI
1023487170
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 2095-39)
Enumeration Date
2015-09-18
Last Update Date
2019-05-08
Business Address
Miss MADELINE DALLMAN LAT
12800 N LAKE SHORE DR
MEQUON, WI 53097-2418
Phone number: 262-993-1669
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Mailing Address
Miss MADELINE DALLMAN LAT
N7529 PAWLING PL
HARTLAND, WI 53029
Phone number:
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