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425 Pine Ridge Blvd Suite 220a Wausau WI 54401-4123 | |
(715) 847-2070 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 425 Pine Ridge Blvd, Wausau, Wisconsin |
Authorized Official Name and Position | Jerry M Yang (SVP & CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7158472526 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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29980 Network Pl Chicago IL 60673-1299 Ph: (715) 847-2304 | 425 Pine Ridge Blvd Suite 220a Wausau WI 54401-4123 Ph: (715) 847-2070 |
NPI Number | 1053548693 |
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Provider Enumeration Date | 06/22/2009 |
Last Update Date | 06/14/2024 |
Identifier | Type | State | Issuer |
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1053548693 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Spine & Brain Group Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2800 Westhill Dr, Suite 200, Wausau, WI 54401 Phone: 715-843-1000 Fax: 715-843-1001 |