Doctor Name: | FRANCIS X VANLIESHOUT |
NPI Number: | 1083852651 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 12424 |
Business Practice Address: | 1730 S Matthias St Appleton, WI - 549154012 |
Business Phone Number: | 9207316257 |
Business Fax Number: | |
Mailing Address: | 1730 S Matthias St, APPLETON |
State: | WI |
Postal Code: | 549154012 |
Phone Number: | 9207316257 |
Fax Number: | |
NPI Enumeration Date: | 02/04/2009 |
NPI Last Update Date: | 02/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 12424 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |