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Individual

ROBERT A BREITENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
123 5TH AVE SE, SPRING GROVE, MN 55974-1318
(507) 498-3302
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
310067
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
335587000
MN
Enumeration date
10/18/2006
Last updated
02/04/2016
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