| Provisions Health | |
|
2522 Golf Rd Ste 2 Eau Claire WI 54701-6033 | |
| (715) 833-0660 | |
| Not Available |
| Full Name | Provisions Health |
|---|---|
| Speciality | Family Medicine |
| Location | 2522 Golf Rd Ste 2, Eau Claire, Wisconsin |
| Authorized Official Name and Position | Shannon Wiggins (PHYSICIAN) |
| Authorized Official Contact | 5173467628 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provisions Health 9557 S Airport Rd Dewitt MI 48820-9104 Ph: () - | Provisions Health 2522 Golf Rd Ste 2 Eau Claire WI 54701-6033 Ph: (715) 833-0660 |
| NPI Number | 1508875840 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 12/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508875840 | NPI | - | NPPES |
| 22-76363 | Other | WI | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101013727 (Michigan) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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