Gl Independence Clinic | |
35791 Osseo Rd Independence WI 54747-9096 | |
(608) 782-7300 | |
Not Available |
Full Name | Gl Independence Clinic |
---|---|
Speciality | Clinic/center |
Location | 35791 Osseo Rd, Independence, Wisconsin |
Authorized Official Name and Position | Kari B Adank (CCO) |
Authorized Official Contact | 6087758025 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gl Independence Clinic 1836 South Ave La Crosse WI 54601-5429 Ph: (608) 782-7300 | Gl Independence Clinic 35791 Osseo Rd Independence WI 54747-9096 Ph: (608) 782-7300 |
NPI Number | 1780636480 |
---|---|
Provider Enumeration Date | 05/17/2006 |
Last Update Date | 03/07/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780636480 | NPI | - | NPPES |
43062500 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Tri-county Memorial Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 35791 Osseo Rd, Independence, WI 54747 Phone: 715-985-2351 Fax: 715-985-3880 |