Provider Demographics
NPI:1407501059
Name:AURORA COMMUNITY CLINIC SC
Entity Type:Organization
Organization Name:AURORA COMMUNITY CLINIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-748-4433
Mailing Address - Street 1:N4895 LANG FARM DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-8889
Mailing Address - Country:US
Mailing Address - Phone:715-748-4433
Mailing Address - Fax:
Practice Address - Street 1:123 W STATE ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-1772
Practice Address - Country:US
Practice Address - Phone:157-484-4337
Practice Address - Fax:715-748-6304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty