Individual
JESSE JOHN SUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 W ADAMS ST, BLACK RIVER FALLS, WI 54615
(715) 284-1867
Mailing address
610 W ADAMS ST, BLACK RIVER FALLS, WI 54615-9110
(715) 284-1867
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69790-20
WI
Other
Enumeration date
06/01/2016
Last updated
06/30/2025
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