Organization
LIFECARE PRACTITIONERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAY D TREPANIER MD (PRESIDENT)
(920) 929-8120
Entity
Organization
Contact information
Practice address
481 E DIVISION ST, 100, FOND DU LAC, WI 54935-3748
(920) 929-8120
(920) 929-8126
Mailing address
481 E DIVISION ST, 100, FOND DU LAC, WI 54935-3748
(920) 929-8120
(920) 929-8126
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
16852
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
PROVIDER TAXONOMY CODE
WI
Enumeration date
11/08/2006
Last updated
08/22/2020
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