| NPI | 1790127454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI PECK VP Revenue Cycle 715-847-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 0M28290) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MI 0M28290) |
| 207X00000X Orthopaedic Surgery (Licence: MI 0M28290) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 0M28290) | |
| 208600000X Surgery (Licence: MI 0M28290) | |
| 208800000X Urology (Licence: MI 0M28290) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 0M28290) | |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2021-05-04 |