Lanita Dorwin

Individual provider Active NPI Home Modifications Contractor · Durand, WI

NPI 1104479955 · NPPES record last updated Jul 22, 2019

Key facts

NPI
1104479955
Entity type
Individual (NPI type 1)
Primary specialty
Home Modifications Contractor 171WH0202X
License
1001999 (WI)
Practice address
W4794 County Road B
Durand, WI 54736-4614
Phone
(715) 672-5679
Fax
(715) 672-5669
NPI assigned
Jul 22, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1001999WIMDHome Modifications Contractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 1001999 WI Yes

Addresses

Primary practice location

W4794 County Road B
Durand, WI 54736-4614

Mailing address

W4794 County Road B
Durand, WI 54736-4614
Phone (715) 672-5679

Other providers in Durand, WI

All providers in Durand, WI · Home Modifications Contractor in Wisconsin

Sources for this page

Verify at the official NPI Registry.