Organization
OSSEO-FAIRCHILD
Active
Organization
OSSEO-FAIRCHILD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY JACOBSON (ADMINISTRATOR)
(715) 597-3141
Entity
Organization
Contact information
Practice address
50900 FRANCIS ST, OSSEO, WI 54758-7103
(715) 597-3141
(715) 597-3606
Mailing address
50900 FRANCIS ST, P O BOX 130, OSSEO, WI 54758-7103
(715) 597-3141
(715) 597-3606
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44233500
—
WI
Enumeration date
10/31/2007
Last updated
10/31/2007
Update your record
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