Provider Demographics
NPI:1083050942
Name:VETERINARY CLINIC BERLIN/RIPON
Entity Type:Organization
Organization Name:VETERINARY CLINIC BERLIN/RIPON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BATENHORST
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:920-361-2101
Mailing Address - Street 1:W1915 CTY ROAD F
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:54923
Mailing Address - Country:US
Mailing Address - Phone:920-361-2101
Mailing Address - Fax:920-361-2150
Practice Address - Street 1:W1915 CTY ROAD F
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:WI
Practice Address - Zip Code:54923
Practice Address - Country:US
Practice Address - Phone:920-361-2101
Practice Address - Fax:920-361-2150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2029174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty