Organization
NORTHERN WISCONSIN BONE & JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARILYN J OLEJNICZAK (BILLING COORDINATOR)
(715) 358-1911
Entity
Organization
Contact information
Practice address
5200 HUMMINGBIRD RD, SUITE 100, WAUSAU, WI 54401-6312
(715) 358-1911
(715) 358-1912
Mailing address
7520 HWY 51 S, MINOCQUA, WI 54548-8943
(715) 358-1911
(715) 358-1912
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1052540001
DMERC
WI
05
—
21298800
—
WI
01
—
CQ2410
RR MEDICARE
WI
Enumeration date
10/22/2009
Last updated
04/16/2010
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