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1121 Highway 102 Rib Lake WI 54470 | |
(715) 427-5701 | |
(715) 427-3863 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 1121 Highway 102, Rib Lake, 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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135 S Gibson St Medford WI 54451-1622 Ph: (715) 748-8100 | 1121 Highway 102 Rib Lake WI 54470 Ph: (715) 427-5701 |
NPI Number | 1265502173 |
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Provider Enumeration Date | 11/08/2006 |
Last Update Date | 06/10/2024 |
Identifier | Type | State | Issuer |
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1265502173 | NPI | - | NPPES |
21303300 | Medicaid | WI |