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Organization
NORTHERN WISCONSIN BONE & JOINT CENTER, LTD
Active
Organization
NORTHERN WISCONSIN BONE & JOINT CENTER, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARILYN OLEJNICZAK (BILLING ADMINISTRATOR)
(715) 358-7965
Entity
Organization
Contact information
Practice address
201 HOSPITAL RD, EAGLE RIVER, WI 54521-8835
(715) 358-1911
(715) 358-1912
Mailing address
7520 US HIGHWAY 51 S, MINOCQUA, WI 54548-9202
(715) 358-1911
(715) 358-1912
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1052540001
DMERC
WI
05
—
21298800
—
WI
01
—
CQ2410
RRMEDICARE
WI
Enumeration date
02/08/2007
Last updated
08/22/2020
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