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401 W Mohawk Dr Tomahawk WI 54487-2274 | |
(715) 453-7200 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 401 W Mohawk Dr, Tomahawk, Wisconsin |
Authorized Official Name and Position | Jerry M Yang (SVP & CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7158472526 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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29980 Network Pl Chicago IL 60673-1299 Ph: (715) 847-2304 | 401 W Mohawk Dr Tomahawk WI 54487-2274 Ph: (715) 453-7200 |
NPI Number | 1558912469 |
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Provider Enumeration Date | 09/23/2019 |
Last Update Date | 06/10/2024 |
Medicare PECOS PAC ID | 9335059856 |
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Medicare Enrollment ID | O20200226002371 |
Identifier | Type | State | Issuer |
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1558912469 | NPI | - | NPPES |