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1477901395
JESSE JOHN SUSA
BLACK RIVER FALLS, WI
NPI
1477901395
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WI 69790-20)
Enumeration Date
2016-06-01
Last Update Date
2024-07-26
Business Address
JESSE JOHN SUSA MD
610 W ADAMS ST
BLACK RIVER FALLS, WI 54615
Phone number: 715-284-1867
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Mailing Address
JESSE JOHN SUSA MD
610 W ADAMS ST
BLACK RIVER FALLS, WI 54615-9110
Phone number: 715-284-1867
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