David Fountain

NPI #1942820428 in West Bend, Wisconsin

Provider Information

NPI Number: 1942820428
Entity Type: Individual
Name: David Fountain
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: Apr 24, 2020
Last Updated: Apr 24, 2020

Practice Location

Address: 726 CREEDWOOD LANE
City: West Bend
State: Wisconsin
ZIP Code: 53095
Phone: (262) 388-6191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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