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213 W Wisconsin Ave Tomahawk WI 54487-1238 | |
(715) 453-5381 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 213 W Wisconsin Ave, Tomahawk, Wisconsin |
Authorized Official Name and Position | Michael Loy (INTERIM CEO) |
Authorized Official Contact | 7158484600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1100 Lake View Dr Wausau WI 54403-6785 Ph: (715) 848-4600 | 213 W Wisconsin Ave Tomahawk WI 54487-1238 Ph: (715) 453-5381 |
NPI Number | 1285749341 |
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Provider Enumeration Date | 08/20/2006 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285749341 | NPI | - | NPPES |
42172800 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | 1681 (Wisconsin) | Primary |