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Mark Garold Pontow
Student in an Organized Health Care Education/Training Program in Appleton, Wisconsin
NPI 1255914735

Mark Garold Pontow is a Student in an Organized Health Care Education/Training Program based in Appleton, WI. Mark Garold Pontow practices in Appleton, WI. The NPI Number for Mark Garold Pontow is 1255914735 and holds a License No. (Wisconsin).

The current practice location address for Mark Garold Pontow is 1506 S Oneida St, Appleton, WI and can be reached out via phone at 920-738-2000.

Location: 1506 S Oneida St, Appleton, WI, 54915-1305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255914735
Provider Name
Mark Garold Pontow
Credential
Provider Entity Type
Individual
Gender
Male
Address
1506 S Oneida St, Appleton, WI, 54915-1305
Phone Number
920-738-2000
Fax Number
Provider Enumeration Date
05/03/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1506 S Oneida St
City
Appleton
State
Wisconsin
Zip
54915-1305
Phone Number
920-738-2000
Fax Number
person
Provider Business Mailing Address Details
Address
1506 S Oneida St
City
Appleton
State
Wisconsin
Zip
54915-1305
Phone Number
920-738-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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