ANDREA JO POULSON-PORT

MANITOWOC, WI
NPI1326280611
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: WI  56118-20)
Enumeration Date2009-04-01
Last Update Date2024-09-24
Business Address
ANDREA JO POULSON-PORT M.D.
4100 DEWEY ST
MANITOWOC, WI 54220-5497
Phone number: 920-686-5700
Mailing Address
ANDREA JO POULSON-PORT M.D.
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 800-326-2250
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