Organization
CHIPPEWA VALLEY NEUROSCIENCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON P KONZEN DO (OWNER)
(715) 831-0811
Entity
Organization
Contact information
Practice address
950 W CLAIREMONT AVE, SUITE B, EAU CLAIRE, WI 54701-6176
(715) 831-0811
(715) 831-0802
Mailing address
3506 OAKWOOD MALL DR STE A, EAU CLAIRE, WI 54701-2639
(715) 831-0811
(715) 831-0802
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
37138021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30067800
—
WI
Enumeration date
02/09/2007
Last updated
05/29/2024
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