Organization
WESTERN WISCONSIN MEDICAL ASSOCIATES
Active
Other names
Vibrant Health Family Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
KERITH W LIJEWSKI MD (MEDICAL DIRECTOR)
(715) 425-6701
Entity
Organization
Contact information
Practice address
1687 E DIVISION ST, RIVER FALLS, WI 54022-1571
(715) 425-6701
(715) 426-3994
Mailing address
1687 E DIVISION ST, RIVER FALLS, WI 54022-1571
(715) 425-6701
(715) 426-3994
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32748700
—
WI
Enumeration date
08/30/2005
Last updated
08/14/2014
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