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212800 Stainless Ave Stratford WI 54484-4325 | |
(715) 687-4211 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 212800 Stainless Ave, Stratford, 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 Attn: Provider Enrollment Services Shp Fl2 Marshfield WI 54449 Ph: (715) 387-5511 | 212800 Stainless Ave Stratford WI 54484-4325 Ph: (715) 687-4211 |
NPI Number | 1760020838 |
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Provider Enumeration Date | 12/19/2019 |
Last Update Date | 10/31/2023 |
Medicare PECOS PAC ID | 2365433224 |
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Medicare Enrollment ID | O20200116002449 |
Identifier | Type | State | Issuer |
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1760020838 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |