| Gregory Cowan Llc | |
|
3301 Cranberry Blvd Floor 2 Weston WI 54476-5216 | |
| (715) 393-3953 | |
| Not Available |
| Full Name | Gregory Cowan Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3301 Cranberry Blvd, Weston, Wisconsin |
| Authorized Official Name and Position | Gregory Scott Cowan (PSYCHOLOGIST) |
| Authorized Official Contact | 7153933953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Cowan Llc 1408 Woodland Ridge Rd Wausau WI 54403-2362 Ph: (715) 675-2183 | Gregory Cowan Llc 3301 Cranberry Blvd Floor 2 Weston WI 54476-5216 Ph: (715) 393-3953 |
| NPI Number | 1538453584 |
|---|---|
| Provider Enumeration Date | 06/07/2011 |
| Last Update Date | 06/07/2011 |
| Medicare PECOS PAC ID | 3779751227 |
|---|---|
| Medicare Enrollment ID | O20110727000674 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538453584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 2343-57 (Wisconsin) | Primary |
| Provider Name | Gregory S Cowan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235166828 PECOS PAC ID: 6709900996 Enrollment ID: I20100824001229 |
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