| |
1160 Rome Center Dr Nekoosa WI 54457-8705 | |
(715) 325-8300 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 1160 Rome Center Dr, Nekoosa, 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 |
---|---|
29980 Network Pl Chicago IL 60673-1299 Ph: (715) 847-2304 | 1160 Rome Center Dr Nekoosa WI 54457-8705 Ph: (715) 325-8300 |
NPI Number | 1477912038 |
---|---|
Provider Enumeration Date | 02/11/2016 |
Last Update Date | 06/14/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477912038 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |