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1396010468
CATIE FERN PONTEL
WALWORTH, WI
NPI
1396010468
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
302R00000X Health Maintenance Organization
(Licence: WI 1652-019)
Enumeration Date
2012-03-21
Last Update Date
2012-08-27
Business Address
-- CATIE FERN PONTEL PTA
270 RIDGE RD
WALWORTH, WI 53184-9526
Phone number: 262-275-2317
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Mailing Address
-- CATIE FERN PONTEL PTA
W4929 PADDOCK DR
ELKHORN, WI 53121-3106
Phone number: 414-687-9526
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