Organization
MARATHON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L. TYLKA (DIRECTOR)
(715) 261-7500
Entity
Organization
Contact information
Practice address
400 E THOMAS ST, WAUSAU, WI 54403-6498
(715) 261-7500
(715) 261-7510
Mailing address
400 E THOMAS ST, WAUSAU, WI 54403-6498
(715) 261-7500
(715) 261-7510
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43112300
—
WI
Enumeration date
04/03/2007
Last updated
08/22/2020
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