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1821089541
E T AYALA
FOND DU LAC, WI
NPI
1821089541
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: WI 21604)
Enumeration Date
2005-11-02
Last Update Date
2007-07-08
Business Address
-- E T AYALA MD
92 E DIVISION ST
FOND DU LAC, WI 54935-4305
Phone number: 920-921-0560
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Mailing Address
-- E T AYALA MD
420 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-926-8340
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