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320 Race St Wisconsin Dells WI 53965-1822 | |
(608) 254-7178 | |
(608) 253-7139 |
Full Name | |
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Speciality | Clinic/center |
Location | 320 Race St, Wisconsin Dells, Wisconsin |
Authorized Official Name and Position | Robert Scott Waters (OWNER) |
Authorized Official Contact | 6082547178 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 357 Wisconsin Dells WI 53965-0357 Ph: (608) 254-7178 | 320 Race St Wisconsin Dells WI 53965-1822 Ph: (608) 254-7178 |
NPI Number | 1306069364 |
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Provider Enumeration Date | 04/10/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1306069364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 27520 (Wisconsin) | Primary |