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102 W Cannery St Greenwood WI 54437-9705 | |
(715) 267-6600 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 102 W Cannery St, Greenwood, 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 Marshfield WI 54449 Ph: (715) 389-0660 | 102 W Cannery St Greenwood WI 54437-9705 Ph: (715) 267-6600 |
NPI Number | 1457999476 |
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Provider Enumeration Date | 12/20/2019 |
Last Update Date | 10/31/2023 |
Medicare PECOS PAC ID | 2365433224 |
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Medicare Enrollment ID | O20200128000451 |
Identifier | Type | State | Issuer |
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1457999476 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |