Cleveland Va Cboc | |
1205 North Ave Cleveland WI 53015-1413 | |
(188) 469-6614 | |
Not Available |
Full Name | Cleveland Va Cboc |
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Speciality | Clinic/center |
Location | 1205 North Ave, Cleveland, Wisconsin |
Authorized Official Name and Position | Agnes E. Deehr (LPN) |
Authorized Official Contact | 9206935600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cleveland Va Cboc 336 E Jefferson Ave Cleveland WI 53015-1530 Ph: (920) 693-8478 | Cleveland Va Cboc 1205 North Ave Cleveland WI 53015-1413 Ph: (188) 469-6614 |
NPI Number | 1154337558 |
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Provider Enumeration Date | 07/31/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1154337558 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 8882-031 (Wisconsin) | Primary |