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1033531108
JOSEPH WHITE EAGLE
BARABOO, WI
NPI
1033531108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WI 16099-131)
Enumeration Date
2014-01-09
Last Update Date
2016-11-30
Business Address
JOSEPH WHITE EAGLE SAC
S2845 WHITE EAGLE RD
BARABOO, WI 53913-9064
Phone number: 608-355-1240
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Mailing Address
JOSEPH WHITE EAGLE SAC
S2845 WHITE EAGLE RD
BARABOO, WI 53913-9064
Phone number: 608-355-1240
Copy
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