Provider Demographics
NPI:1881927812
Name:GAIL A WEINAND
Entity type:Organization
Organization Name:GAIL A WEINAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEINAND
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:715-369-7474
Mailing Address - Street 1:203 SCHIEK PLZ
Mailing Address - Street 2:P O BOX 1161
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-3364
Mailing Address - Country:US
Mailing Address - Phone:715-369-7474
Mailing Address - Fax:715-369-7475
Practice Address - Street 1:203 SCHIEK PLZ
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3364
Practice Address - Country:US
Practice Address - Phone:715-369-7474
Practice Address - Fax:715-369-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225X00000X261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty