CARLY DIANE TRIEBENSEE

LAKE GENEVA, WI
NPI1093548984
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WI  8106-23)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2024-08-26
Last Update Date2024-09-24
Business Address
CARLY DIANE TRIEBENSEE PA
N2950 STATE ROAD 67
LAKE GENEVA, WI 53147-2655
Phone number: 262-245-0535
Mailing Address
CARLY DIANE TRIEBENSEE PA
9615 HARVEST MOON LN APT 413
VERONA, WI 53593-9676
Phone number: 920-946-9353