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625 Peterson Av Phillips WI 54555-1430 | |
(715) 339-4035 | |
(715) 339-4036 |
Full Name | |
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Speciality | Clinic/Center |
Location | 625 Peterson Av, Phillips, 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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135 S Gibson St Medford WI 54451-1622 Ph: (715) 748-8100 | 625 Peterson Av Phillips WI 54555-1430 Ph: (715) 339-4035 |
NPI Number | 1891971768 |
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Provider Enumeration Date | 01/10/2008 |
Last Update Date | 06/10/2024 |
Medicare PECOS PAC ID | 5799688602 |
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Medicare Enrollment ID | O20100422000204 |
Identifier | Type | State | Issuer |
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1891971768 | NPI | - | NPPES |