Organization
NORTHERN LIGHTS CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRENCE A HNATUK MD (PRESIDENT)
(715) 735-3187
Entity
Organization
Contact information
Practice address
3200 SHORE DR, MARINETTE, WI 54143-4292
(715) 735-3187
(715) 735-7072
Mailing address
3200 SHORE DR, PO BOX 437, MARINETTE, WI 54143-4292
(715) 735-3187
(715) 735-7072
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
06/21/2006
Last updated
10/18/2010
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