Chn Medical Center - Redgranite | |
402 Preston Ln Redgranite WI 54970-9350 | |
(920) 566-0637 | |
(920) 566-0638 |
Full Name | Chn Medical Center - Redgranite |
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Speciality | Family Medicine |
Location | 402 Preston Ln, Redgranite, Wisconsin |
Authorized Official Name and Position | Jayne Plagenz (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 9203615431 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chn Medical Center - Redgranite 402 Preston Ln Redgranite WI 54970-9350 Ph: (920) 566-0637 | Chn Medical Center - Redgranite 402 Preston Ln Redgranite WI 54970-9350 Ph: (920) 566-0637 |
NPI Number | 1962768937 |
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Provider Enumeration Date | 04/04/2012 |
Last Update Date | 04/04/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962768937 | NPI | - | NPPES |
11011000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |