| Brotoloc | |
|
2710 N Town Hall Rd Eau Claire WI 54703-9687 | |
| (715) 874-5050 | |
| Not Available |
| Full Name | Brotoloc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2710 N Town Hall Rd, Eau Claire, Wisconsin |
| Authorized Official Name and Position | Joel D. Breed (PRESIDENT) |
| Authorized Official Contact | 7158325085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brotoloc 2710 N Town Hall Rd Eau Claire WI 54703-9687 Ph: (715) 874-5050 | Brotoloc 2710 N Town Hall Rd Eau Claire WI 54703-9687 Ph: (715) 874-5050 |
| NPI Number | 1760525091 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 04/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760525091 | NPI | - | NPPES |
| 42180500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1907 (Wisconsin) | Primary |
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