Organization
PAIN CENTERS OF WISCONSIN - WAUSAU, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VISHAL LAL (CHIEF EXECUTIVE OFFICER)
(414) 325-7246
Entity
Organization
Contact information
Practice address
400 WESTWOOD DR, SUITE 200, WAUSAU, WI 54401-7801
(715) 261-0425
(715) 261-2450
Mailing address
4131 W LOOMIS RD STE 300, GREENFIELD, WI 53221-2059
(414) 325-7246
(414) 325-3770
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2012
Last updated
11/28/2016
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