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Organization

PREMIER CLINICS OF WISCONSIN, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT ROTAR CRNA (PRESIDENT)
(715) 892-4835
Entity
Organization

Contact information

Practice address
200 DIVISION ST STE J, STEVENS POINT, WI 54481-1843
(715) 544-1774
(715) 544-1772
Mailing address
520 VINCENT ST, STEVENS POINT, WI 54481-1848
(715) 544-1774
(715) 544-1772

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
207XS0117X
Orthopaedic Surgery of the Spine Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
208600000X
Surgery Physician
208VP0000X
Pain Medicine Physician
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Enumeration date
01/19/2010
Last updated
02/20/2025
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