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216 S Adams St Saint Croix Falls WI 54024-9449 | |
(715) 483-3221 | |
(715) 483-0507 |
Full Name | |
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Speciality | Clinic/Center |
Location | 216 S Adams St, Saint Croix Falls, Wisconsin |
Authorized Official Name and Position | Mike Youso (CFO) |
Authorized Official Contact | 7154830535 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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235 E State St Saint Croix Falls WI 54024-4117 Ph: (715) 483-3221 | 216 S Adams St Saint Croix Falls WI 54024-9449 Ph: (715) 483-3221 |
NPI Number | 1669988861 |
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Provider Enumeration Date | 12/26/2017 |
Last Update Date | 01/25/2023 |
Medicare PECOS PAC ID | 9335032184 |
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Medicare Enrollment ID | O20180803000941 |
Identifier | Type | State | Issuer |
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1669988861 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 1041 (Wisconsin) | Primary |