Full Name | |
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Speciality | Clinic/Center |
Location | 1711 York St, Bloomer, Wisconsin |
Authorized Official Name and Position | Kathleen Bressler (COO, AO) |
Authorized Official Contact | 7159756018 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1000 N Oak Ave Provider Enrollment Shp Fl2 Marshfield WI 54449-5703 Ph: (715) 389-0660 | 1711 York St Bloomer WI 54724-1902 Ph: (715) 568-6220 |
NPI Number | 1992345771 |
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Provider Enumeration Date | 01/09/2020 |
Last Update Date | 10/31/2023 |
Medicare PECOS PAC ID | 5698071173 |
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Medicare Enrollment ID | O20200225002604 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992345771 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |