Provider Information for 1255326161
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LEEANN E VAN VREEDE MS
Other Names:Former Name:Miss LEEANN E BOCK MASex: Female
NPI: 1255326161
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1255326161 | ||||||||||||
| Enumeration Date | 2005-09-16 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1836 SOUTH AVE LA CROSSE, WI 54601-5429 United States Phone: 608-782-7300 | Fax: | ||||||||||||
| Primary Practice Address | 1910 SOUTH AVE LA CROSSE, WI 54601-5467 United States Phone: 608-782-7300 | Fax: | ||||||||||||
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