Provider Demographics
NPI:1841535341
Name:SNF CARE INC
Entity type:Organization
Organization Name:SNF CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HETTRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-843-2394
Mailing Address - Street 1:7137 236TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:53168-8975
Mailing Address - Country:US
Mailing Address - Phone:262-843-4422
Mailing Address - Fax:262-843-1166
Practice Address - Street 1:7137 236TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:WI
Practice Address - Zip Code:53168-8975
Practice Address - Country:US
Practice Address - Phone:262-843-4422
Practice Address - Fax:262-843-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty