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Organization
ST CLARE MEMORIAL HOSPITAL, INC
Active
Organization
ST CLARE MEMORIAL HOSPITAL, INC
Active
Parent organization
ST CLARE MEMORIAL HOSPTIAL, INC
Other names
St Clare Memorial Hospital Physical Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST CLARE MEMORIAL HOSPTIAL, INC
Authorized official
DANIEL DEGROOT (CEO)
(920) 846-3444
Entity
Organization
Contact information
Practice address
855 S MAIN ST, OCONTO FALLS, WI 54154-1241
(920) 846-3444
(920) 846-0754
Mailing address
855 S MAIN ST, OCONTO FALLS, WI 54154-1241
(920) 846-3444
(920) 846-0250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1326349135
CMH SB NPI
WI
01
—
1376716746
KRAUSE NPI
WI
01
—
1619140092
WAGNER NPI
WI
01
—
1639342611
COLLINS NPI
WI
01
—
1811135338
GASSER NPI
WI
01
—
1851477913
CMH NPI
—
Enumeration date
06/11/2010
Last updated
12/23/2021
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