Provider Demographics
NPI:1578877239
Name:WISCONSIN REPRODUCTIVE HEALTH NETWORK INC
Entity Type:Organization
Organization Name:WISCONSIN REPRODUCTIVE HEALTH NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LON
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-675-9858
Mailing Address - Street 1:719 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-2965
Mailing Address - Country:US
Mailing Address - Phone:715-675-9858
Mailing Address - Fax:715-675-5475
Practice Address - Street 1:719 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-2965
Practice Address - Country:US
Practice Address - Phone:715-675-9858
Practice Address - Fax:715-675-5475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical