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1015 Angelus Dr Nekoosa WI 54457-1617 | |
(715) 886-2100 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 1015 Angelus Dr, Nekoosa, Wisconsin |
Authorized Official Name and Position | Thomas Kaminski (DIRECTOR OF PFS) |
Authorized Official Contact | 7154227739 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1160 Rome Center Dr Nekoosa WI 54457-8705 Ph: (715) 325-7422 | 1015 Angelus Dr Nekoosa WI 54457-1617 Ph: (715) 886-2100 |
NPI Number | 1508927559 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508927559 | NPI | - | NPPES |
32844400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |