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Individual

BARTLEY R KNEELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2351
Mailing address
3000 WESTHILL DR, SUITE 303, WAUSAU, WI 54401-3795

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40463
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32528700
WI
Enumeration date
07/10/2006
Last updated
12/07/2007
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