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1321 Creston Park Dr Janesville WI 53545-1126 | |
| (608) 757-1217 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1321 Creston Park Dr, Janesville, Wisconsin |
| Authorized Official Name and Position | Deborah Jb Gustafson (MANAGER PATIENT ACCOUNTS) |
| Authorized Official Contact | 6083645123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1321 Creston Park Dr Janesville WI 53545-1126 Ph: () - | 1321 Creston Park Dr Janesville WI 53545-1126 Ph: (608) 757-1217 |
| NPI Number | 1407999337 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 09/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407999337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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