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660 Vandeberg St Baldwin WI 54002-3251 | |
(715) 688-7411 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 660 Vandeberg St, Baldwin, Wisconsin |
Authorized Official Name and Position | Tara Denise Scott (IMPLEMENTATION MANAGER) |
Authorized Official Contact | 4236029530 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1110 Market St Ste 502 Chattanooga TN 37402-3310 Ph: (423) 602-9530 | 660 Vandeberg St Baldwin WI 54002-3251 Ph: (715) 688-7411 |
NPI Number | 1154028942 |
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Provider Enumeration Date | 02/13/2023 |
Last Update Date | 08/17/2023 |
Identifier | Type | State | Issuer |
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1154028942 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |