Individual
BRUCE A WILBER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC
Contact information
Practice address
N2150 KESAEHKAHTEK RD, GRESHAM, WI 54128-9602
(715) 799-3835
(715) 799-3836
Mailing address
N2150 KESAEHKAHTEK RD, GRESHAM, WI 54128-9602
(715) 799-3835
(715) 799-3836
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15433131
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41162800
—
WI
Enumeration date
08/20/2008
Last updated
08/20/2008
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