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Search › Wisconsin › 225200000X

Gowa Lama

NPI 1205568763 · on the registry since 2022 · sole proprietor

Practice

Address
1635 S 21st St
Manitowoc, WI 54220
Phone
(920) 684-7171
Organisation at this address
St. Mary'S Home For The Aged, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
3

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-06-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin