Organization
PHYSICAL MEDICINE OF NORTHERN WISCONSIN SC
Active
Organization
PHYSICAL MEDICINE OF NORTHERN WISCONSIN SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC R DURETTE MD (OWNER)
(715) 365-5256
Entity
Organization
Contact information
Practice address
586 SHEPARD ST, RHINELANDER, WI 54501
(715) 365-5256
(715) 365-5258
Mailing address
586 SHEPARD ST, RHINELANDER, WI 54501
(715) 365-5256
(715) 365-5258
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31572600
—
WI
Enumeration date
12/01/2006
Last updated
02/11/2008
Update your record
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