Organization
DRG CLINICAL, SC
Active
Other names
Weston Psychiatric
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GOUTHRO MD (OWNER)
(715) 204-9808
Entity
Organization
Contact information
Practice address
5703 MEMORIAL CT, WESTON, WI 54476-6502
(715) 204-9808
Mailing address
5703 MEMORIAL CT, WESTON, WI 54476-6502
(715) 204-9808
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
07/21/2025
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