Powers, Lara M

Powers, Lara M is an individual health care provider with primary practice located at 1409 Cleveland Ave , Marinette WI 54143-3918. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Powers, Lara M can be contacted via phone (715) 732-0832.

Contact Information

Primary practice address
1409 Cleveland Ave Marinette WI 54143-3918
Phone: (715) 732-0832
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45322020 Wisconsin

Profile Details

NPI number 1730176140
LBN Legal business name Powers, Lara M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Apr 6th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730176140 NPPES
Wisconsin MEDICAID 34346300
Wisconsin Other P00104680

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