Provider Demographics
NPI:1558638080
Name:BADGER VETERINARY HOSPITAL
Entity Type:Organization
Organization Name:BADGER VETERINARY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VETERINARIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CLARE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:608-754-1888
Mailing Address - Street 1:3113 MCCORMICK DR
Mailing Address - Street 2:P.O. BOX 2258
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-9636
Mailing Address - Country:US
Mailing Address - Phone:608-754-1888
Mailing Address - Fax:
Practice Address - Street 1:3113 MCCORMICK DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-9636
Practice Address - Country:US
Practice Address - Phone:608-754-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5406-50261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center