Provider Demographics
NPI:1356656771
Name:KLASINSKI NEUROCARE, SC
Entity Type:Organization
Organization Name:KLASINSKI NEUROCARE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:WIMME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-344-0607
Mailing Address - Street 1:500 VINCENT ST STE B
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1842
Mailing Address - Country:US
Mailing Address - Phone:715-344-0607
Mailing Address - Fax:715-544-4175
Practice Address - Street 1:500 VINCENT ST STE B
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1842
Practice Address - Country:US
Practice Address - Phone:715-344-0607
Practice Address - Fax:715-544-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty