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2321 Stout Rd Menomonie WI 54751-7003 | |
| (715) 235-5531 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2321 Stout Rd, Menomonie, Wisconsin |
| Authorized Official Name and Position | Julie Hansen (CFO) |
| Authorized Official Contact | 7158385270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2321 Stout Rd Menomonie WI 54751-7003 Ph: (715) 235-5531 | 2321 Stout Rd Menomonie WI 54751-7003 Ph: (715) 235-5531 |
| NPI Number | 1235666967 |
|---|---|
| Provider Enumeration Date | 05/12/2017 |
| Last Update Date | 05/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235666967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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