Individual
MR. BRUCE W RETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
501 PARK AVE, OCONTO, WI 54153-1612
(920) 834-7000
(920) 834-6889
Mailing address
501 PARK AVE, OCONTO, WI 54153-1612
(920) 834-7000
(920) 834-6889
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32980400
—
WI
05
—
42140300
—
WI
05
—
43427200
—
WI
Enumeration date
01/05/2007
Last updated
06/08/2011
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