Full Name | |
---|---|
Speciality | General Practice |
Location | 102 Jay St, La Crosse, Wisconsin |
Authorized Official Name and Position | Brett Gall (DIRECTOR PAYOR CONTRACTING) |
Authorized Official Contact | 3042252500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1001 Consol Energy Dr Canonsburg PA 15317-6506 Ph: (304) 225-2500 | 102 Jay St La Crosse WI 54601-4381 Ph: (608) 394-3437 |
NPI Number | 1952064636 |
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Provider Enumeration Date | 10/19/2021 |
Last Update Date | 11/15/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952064636 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Premise Health Of Wisconsin Medical, S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2222 Kwik Trip Way, La Crosse, WI 54603 Phone: 608-781-4460 Fax: 608-781-5587 | |
Durtsche Chiropractic Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2045 32nd St S, La Crosse, WI 54601 Phone: 608-788-1170 | |
Gundersen Lutheran Medical Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1111 7th St S, La Crosse, WI 54601 Phone: 608-782-7300 |