# BRIAN VAN HOOZEN DO SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851563472
- **Authorized official:** DR. BRIAN L VAN HOOZEN D.O. (OWNER)
- **Authorized official phone:** (920) 982-7900

## Contact information

- **Practice address:** 1505 MILL ST, NEW LONDON, WI 54961-2187
- **Practice address phone:** (920) 982-7900
- **Practice address fax:** (920) 982-7995
- **Mailing address:** PO BOX 96, NEW LONDON, WI 54961-0096
- **Mailing address phone:** (920) 982-7900
- **Mailing address fax:** (920) 982-7995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 32699 | WI | Yes |

## Other

- **Enumeration date:** 03/25/2008
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30054700 | — | WI |
| 01 | — | 32699 | LICENSE NUMBER | WI |