Individual
DR. MARY JO CRISSLER BELANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45697
MN
207R00000X
Internal Medicine Physician
Primary
60515
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0406200
MEDICA
MN
01
—
172K2CR
BC BS
MN
01
—
585241040263
PREFERRED ONE
MN
05
—
772660100
—
MN
Enumeration date
05/13/2006
Last updated
06/02/2015
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