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Organization
ST CLARE MEMORIAL HOSPITAL, INC
Active
Organization
ST CLARE MEMORIAL HOSPITAL, INC
Active
Parent organization
ST CLARE MEMORIAL HOSPITAL, INC
Other names
St Clare Memorial Hosptial Physical Therapy Gillett Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST CLARE MEMORIAL HOSPITAL, INC
Authorized official
DANIEL DEGROOT (CEO)
(920) 846-3444
Entity
Organization
Contact information
Practice address
340 N GREEN BAY AVE, GILLETT, WI 54124-9325
(920) 855-2823
(920) 855-6343
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1417188673
BURKEL NPI
WI
01
—
1851477913
CMH NPI
—
Enumeration date
06/11/2010
Last updated
12/23/2021
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